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Digitized  by  the  Internet  Archive 

in  2010  with  funding  from 

Open  Knowledge  Commons 


http://www.archive.org/details/historyoflifeofOOadam 


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HISTORY  OF  THE  LIFE 


OF 


D.  HAYES  AGNEW, 

M.D.,  LL.D. 


J.  HOWE  ADAMS,  M.D. 


PHILADELPHIA   AND    LONDON: 

THE  F.  A.  DAVIS  COMPANY,  PUBLISHERS, 

1892. 


Copyright  1892, 
By  J.  HOWE  ADAMS,  M.D., 

Philadelphia. 


Philadelphia,  Pa.,  U.  S.  A. 

The  Medical  Bulletin  Printing  House, 

1916  Cherry  Street. 


PREFACE. 

Dr.  Agnew  lived  his  life  without  thought  of  a  biographer ; 
he  took  no  care  to  preserve  the  data  of  his  life-work ;  in  con- 
sequence, after  his  death,  but  little  available  material  could  be 
found  among  his  papers.  Through  the  efforts  of  Mrs.  Agnew, 
however,  and  from  the  memory  and  material  in  the  hands  of 
his  friends,  the  work  has  been  at  length  done.  It  was  the  in- 
tention of  the  writer  to  give  the  original  sources  from  which 
data  were  obtained  throughout  the  book,  but  these  references 
have  been  so  many  and  varied  that  it  was  soon  found  that  it 
would  constitute  a  source  of  annoyance  to  the  reader;  con- 
sequently, in  the  Appendix  all  credits  are  given. 

It  has  been  a  great  aid,  as  well  as  pleasure,  to  see  the  eager- 
ness and  love  displayed  by  every  one  in  giving  information  in 
regard  to  Dr.  Agnew's  life.  It  seemed  to  be  a  pleasant  task,  on 
the  part  of  all,  to  do  what  they  could  for  their  beloved  friend 
and  colleague ;  at  the  expense  of  considerable  toil,  trouble, 
and  time,  they  have  fully  performed  this  labor  of  love.  With- 
out such  assistance  the  biography  would  have  been  sadly 
incomplete. 

In  writing  this  book  the  style  and  treatment  have  been 
modeled,  as  far  as  possible,  upon  Dr.  Agnew's  own  idea  of  pro- 
priety and  methods  of  thought.  A  biographer,  in  preparing 
the  life  of  his  hero,  loves  to  dwell  chiefly  on  those  efforts  and 
achievements  which  have  attracted  public  admiration, — on  those 
master-strokes  in  the  life  of  his  subject  which  have  raised  him 
above  the  level  of  his   fellow-men, — leaving  out    those  lesser 

(iii) 


IV  PREFACE. 

characteristics  which  not  only  serve  to  consoUdate  the  character 
and  lead  to  success,  but  which,  from  their  multiform  points  in 
which  they  come  in  contact  with  common  humanity,  confer  a 
personal  interest  in  the  life.  The  glory  of  the  Alps  does  not 
consist  merely  in  the  mighty  mountain-peaks  which  send  their 
spires  to  heaven,  clothed  with  sunshine  and  cloud ;  the  foot-hills 
clustering  at  the  mountain-base,  the  rippling  streams,  and 
pleasant  meadows  catch  equally  the  eye  of  the  pleasure-seeking 
tourist  and  increase  the  beauties  above  by  contrast. 

And  so  with  Dr.  Agnew :  it  was  not  alone  those  achieve- 
ments which  bore  the  stamp  of  originality,  which  heralded  his 
name  on  the  wings  of  the  wind  and  made  it  a  tower  of  strength 
which  we  have  endeavored  to  depict;  but  there  were  other 
charms  of  social  and  personal  life  which  have  made  his  memory 
fragrant  in  the  minds  of  his  friends.  In  endeavoring  thus  to 
show  his  life  and  its  effect  upon  the  American  world,  these 
lesser  points  have  been  included  as  far  as  possible. 

If  any  better  conception,  however  shadowy  and  undecided, 
of  the  life,  character,  and  accomplishments  of  this  grandest 
figure  in  American  medicine,  can  be  gained  from  reading  this 
biography,  the  writer  will  feel  that  the  labor  of  love  was  not 
done  in  vain. 

December  20,  1892. 


CONTENTS. 


CHAPTER  I. 

PAGE 

Lineage  op  the  Agnew  Family, 1 

CHAPTER   II. 

The  Early  Life  of  Dr.  Agnew,     .......       36 

CHAPTER   IIL 

The  Story  of  Dr.  Agnew's  Business  Venture,     ....       60 

CHAPTER    lY. 

Dr.    Agnew's    Connection  with    the   Philadelphia   School    op 

Anatomy, 76 

CHAPTER   y. 
Dr.  Agnew's  Early  Life  in  Philadelphia, 106 

CHAPTER   YL 

Dr.  Agnew's  Life  from  1860  to  1870,  .         .        .        .        .        .     128 

CHAPTER  YIL 

Dr.  Agnew  as  Professor  op  Surgery, 154 

CHAPTER   YIIL 
Dr.  Agnew's  Original  Work  in  Surgery, 173- 

CHAPTER   IX. 
Dr.  Agnew  as  a  Writer, ,        .193 

CHAPTER   X. 
The  Garfield  Case, 220 

CHAPTER  XL 

Dr.  Agnew's  Home-Lipe, 250 

(V) 


VI  CONTENTS. 

CHAPTER  XII. 

PAGE 

Dr.  Agnew's  Later  Life,       .        .        .        ...        .        .        .    265 

CHAPTER   XIII. 
The  Jubilee  of  Dr.  Agnew, 298 

CHAPTER   XIY. 

Dr.  Agnew's  Retirement  from  the  University  of  Pennsylvania,    318 

CHAPTER   XV. 

Dr.  Agnew's  Final  Sickness,  Death,  and  Funeral,    .        .        .    339 

CHAPTER   XYI. 

Estimate  of  Dr.  Agnew's  Position  in  Surgery,  ....     353 

Appendix, 365 


LIST  OF   ILLUSTRATIONS. 


Uhle  Portrait  op  Dr.  Agnew,   .        .                        ...      Frontispiece 
The  Agnew  Coat  of  Arms, Facing  pa"-e      18 


The  Charcoal-House  of  the  Pleasant  Garden  Iron- 
Works,     

The  Philadelphia  School  of  Anatomy,    .        .        .        . 


Dr.  Agnew  in  1858, 


Dr.  Agnew  in  1867, 


Fac-simile    of    Title-Page  of   Japanese    Edition   of 
Dr.  Agnew's  "Surgery," 


Dr.  Agnew  in  1876, 


Dr.  Agnew  in  1879, 


Dr.  Agnew  in  1883, 


Dr.  Agnew  in  1884, 


Dr.  Agnew  in  1887, 


Dr.  Agnew  in  Clinique, 
Dr.  Agnew  in  1890^ 


•   • 


68 


I  n-c 


108 
133 

163 
178 
204 
230 
273 
290 
333 
348 


(Vii) 


CHAPTER   L 

Lineage  of  the  Agnew  Family. 

The  earliest  record  of  the  Agnew  family,  which  can  be 
definitely  and  connectedly  followed  down  to  the  present  time, 
comes  from  Agneaux,  a  quaint  little  village  in  northeni  France, 
from  which  the  family  derives  its  name.  This  form  of  origin 
of  surname  is  not  unusual,  for  the  most  ancient  and  most  honor- 
able names  found  at  present  in  Great  Britain  and  Ireland  are 
derived  from  the  names  of  places  in  Normandy  or  in  neighbor- 
ing parts  of  France.  In  fact,  there  is  no  village  in  Xormandy 
which  has  not  given  its  name  to  some  family  in  England. 
Genealogists  have  decided  that  this  is  the  most  common  form 
of  the  derivation  of  English  and  Scottish  surnames,  exceeding 
those  derived  from  occupations,  mental  characteristics,  Christian 
names,  and  sobriquets. 

It  has  further  been  conceded,  that  it  was  the  universal 
custom  for  the  place  to  give  the  name  to  the  family,  not  the 
family  to  the  place.  This  is  the  reverse  of  the  process  in 
America.  In  this  country  the  family  has  invariably  given  the 
name  to  the  place.  The  little  town  of  Agnew  in  Lancaster 
County,  Nebraska,  named  in  honor  of  Dr.  Agnew.  is  a  typical 
example  of  this  method.  It  shows  the  space  of  time  which  has 
elapsed,  and  the  changes  in  living  and  civilization,  between  the 
Agneaux  of  the  old  world  and  the  Agnew  of  the  newer  continent. 

The  name  Agneaux  is  Norman-French  for  "  lamb,"  being 
derived,  of  course,  originally,  from  the  Latin  term  agnus,  a 
word  of  the  same  signification.  The  variety  of  ways  in  which 
the  name  has  been  spelled  is  numerous,  Agneau.  Agneaux, 
Agneux,  Aigneux,  Aigneaux,  Aignel ;  tlie  Latinized  forms  are 
Agnelli,  Agnella,  Agnellus ;  the  modernized  forms  are  Agneu, 
Agnieu,  and  Agnew.  The  word  •'  agneau "  in  French  still 
bears  its  original  signification  of  ■•  lamb." 

(1) 


2  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

The  Normans,  or  Norsemen,  as  is  well  known,  were  not  of 
French  origin,  but  were  bold,  adventurous  explorers  from  the 
north  of  Europe,  who  fell  in  great  swarms  upon  the  neighbor- 
ing sea-board  countries,  seizing  lands  for  their  own  use,  and 
carrying  death  and  destruction  to  the  original  inhabitants. 

Agneaux,  this  little  Norman  town,  which  has  been  dead  to 
the  world  for  many  centuries,  holds,  then,  the  honor  of  being 
the  originating  place  of  the  ancient  and  honorable  family  of 
Agnew.  Here  was  moulded  into  permanent  form,  this  clannish 
family,  which  all  the  vicissitudes  of  rude  and  stormy  times  eonld 
not  tear  asunder.  This  place  is  still  a  village  of  less  than  500 
inhabitants.  It  stands  solitary  and  unprogressive,  far  from  the 
nearest  railroad  station,  although  it  seems  unfair  to  compare 
such  a  quaint  old  place  with  such  a  modern  creation  as  the  rail- 
road. It  is  not  large  or  important  enough  to  be  found  in  the 
French  gazetteers,  and  even  a  diligent  search  of  maps  in  Paris 
fails  to  reveal  its  location.  This  quaint  spot  is  large  enough, 
however,  to  be  governed,  according  to  French  customs,  by  a 
mayor.  It  is  located  in  the  Departement  de  la  Manche,  near 
the  city  of  Saint-Lo.  The  Department  of  Manche  is  on  the 
northwestern  coast  of  France,  jutting  into  the  English  Channel ; 
it  derives  its  name  from  the  French  term  for  the  English  Chan- 
nel, "  La  Manche."  Its  bold,  unprotected  position  is  just  such 
an  one  open  to  the  invasion  of  such  hardy  seamen  as  the 
Norsemen. 

There  still  exists  in  Agneaux  an  ancient  chateau,  belong- 
ing to  the  Marquis  de  Ste.  Marie  d'Agneaux,  which  was  quite 
capable  of  resisting  a  siege.  Around  the  memory  of  this  ancient 
castle  many  of  the  romantic  legends  of  Normandy  have  been 
woven.  At  the  time  when  the  Huguenots  were  driven  from 
France,  during  the  reigns  of  Henri  III  and  Henri  IV,  this 
castle  formed  one  of  the  headquarters  for  the  Protestants.  The 
scion  of  this  ancient  family  espoused  this  religion,  and  threw 
all  liis  resources  to  the  defense  of  its  adherents. 

The  names  of  Agneaux  and  Aigneaux  are  not  uncommon 


LINEAGE    OF    TDE   AGNEW   FAMILY.  3 

in  this  region,  although  there  has  been  a  general  exodus  from 
this  country  in  the  past  eight  hundred  years. 

The  explanation  of  this  exodus  of  the  Agneaux  from  Nor- 
mandy is  seen  in  studying  the  history  of  the  family.  Family 
tradition  reports  that  at  the  time  of  the  Norman  conquest  of 
England  by  William  the  Conqueror,  in  the  eleventh  century,  the 
chief  body  of  the  family  came  with  him,  settling  in  England  and 
Scotland.  This  was  an  age  of  rough  manners  and  brutal  con- 
quest, and  it  required  the  banding  together  of  large  bodies  of 
well-built,  courageous  men  to  survive.  Some  of  the  family, 
filled  with  this  restless  spirit  of  conquest  which  was  the  feature 
of  the  age,  did  not  linger  in  Great  Britain,  but  followed  "Strong 
Bow,"  Richard  de  Clare,  Earl  of  Strigul,  to  Ireland,  rendering 
efficient  aid  to  him  in  the  conquest  of  this  island,  in  the  twelfth 
century. 

A  further  element  which  assisted  in  driving  the  Agneaux 
who  remained  in  France  after  the  Norman  conquest  from  their 
native  spot  is  explained  in  an  exhaustive  work  entitled  "  Prot- 
estant Exiles  from  France  in  the  Reign  of  Louis  XIY,  or  the 
Huguenots  and  their  Descendants  in  Great  Britain  and  Ireland," 
by  the  Rev.  David  C.  A.  Agnew.  This  work,  which  includes  a 
complete  list  of  all  the  families  which  comprised  this  religious 
body  joining  in  the  exodus,  shows  that  many  of  the  Agneaux 
who  were  left  behind  at  the  time  of  the  Norman  conquest 
became  Huguenots  at  the  time  of  the  Reformation. 

The  Agneaux  were  moderately  numerous  in  France  from 
the  ninth  to  the  sixteenth  centuries.  As  early  as  the  tenth 
century,  knights  of  this  name  swelled  the  ranks  of  French 
chivalry  and  acquired  landed  estates  in  several  French  prov- 
inces ;  their  heraldic  achievements  are  to  be  found  recorded  in 
the  rolls  of  the  ancient  nobility  of  Normandy,  Burgundy,  and 
Provence.  The  first  member  of  the  family  whose  name  is  defi- 
nitely known,  Agneaux  de  ITsle,  lived  in  the  neighborhood  of 
Caen,  in  the  arondissement  of  Bayeux.  He  was  Lord  of  ITsle 
and  Auval,  his  heraldic  bearing  being  Three  Holy  Lambs,  on 


4  LIFE    OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

an  azure  sliield.  He  was  also  entitled  to  carry  "  two  bars  vert 
on  a  golden  sliield  surrounded  by  an  orle  of  martlets"  as  Lord 
of  Auval.  This  latter  achievement,  carried  first  as  an  addition, 
was  soon  afterward  adopted,  in  place  of  the  original  bearing  of 
the  family,  by  his  descendants, — these  gentlemen  probably  con- 
sidering the  Holy  Lamb  as  too  peaceful  an  emblem  for  such 
restless  adventurers. 

From  Agneaux  de  I'lsle  sprang  various  families,  all  of 
which  prospered, — four  of  which  held  seignorial  fiefs  in  Nor- 
mandy, a  fifth  in  Burgundy,  and  a  sixth  branch  in  Provence.    / 

Sir  Philip  d' Agneaux,  the  heir  of  line  of  the  senior  branch, 
was  created  a  banneret,  for  military  services,  in  1228;  his  father 
and  uncle  were  already  knights.  Sir  John  d' Agneaux  was  one 
3f  the  companions  of  de  Harcourt,  Admiral  of  Prance,  in  a  voy- 
age which  he  undertook  in  1295;  while  in  the  Book  of  Achieve^ 
ments,  drawn  up  by  command  of  Charles  V  of  France,  in  1368, 
a  Sir  Fulke  and  a  Sir  William  d' Agneaux  are  both  honorably 
mentioned.  An  off'shoot  of  the  same  stem,  Agneaux,  Lord  of 
Alencourt,  adopted  as  his  arms  "  three  crescent  gules,  upon  a 
shield  of  gold."  Both  these  crescents  and  the  martlets  are 
special  indications  of  good  service  done  against  the  infidels,  or 
of  long  voyages  of  discovery  and  adventure. 

The  line  of  the  Alencourts  ended  in  an  heiress ;  she  gave 
her  name,  however,  to  her  descendants,  and  this  branch  of  the 
family  is  styled  Ste.  Marie  d' Agneaux.  These  Agneaux  are 
traced  for  many  generations  in  the  "Armorial  de  France."  Jean 
Jacques  Bene  de  Ste.  Marie  d' Agneaux,  of  this  branch  of  the 
family,  was  famous  during  the  reign  of  Louis  XV. 

History  reports  that  a  number  of  the  members  of  the  family 
who  remained  in  Normandy  after  the  Norman  conquest  gained 
distinction  in  other  ways.  Robert  and  Antoine  Agneaux,  or, 
as  the  name  was  then  written,  Aigneaux,  born  in  Normandy  in 
the  sixteenth  century,  translated  "Virgil"  into  French  in  1582. 
This  work  became  popular,  and  stands  even  to-day  as  one  of 
the  great  landmarks  among  the  translations  of  the  Middle  Ages. 


LINEAGE    OF    THE    AGNEW    FAMILY.  5 

The  chief  interest  centres,  however,  in  that  branch  of  the 
Ag-new  family  which  settled  in  Scotland.  It  was  in  County- 
Wigtown,  in  southwest  Scotland,  which  juts  with  bold  outline 
into  the  North  Channel  and  the  Irish  Sea,  that  the  principal 
branch  of  this  bold,  adventurous  family  finally  settled.  Here, 
in  the  wild  and  unsettled  times  of  the  early  part  of  the  history 
of  Scotland,  they  held  theii:  own,  and  became  prominent  in  that 
country  at  a  time  when  great  physical  development  was  as 
necessary  for  existence  as  shrewdness  and  intelligejice.  The 
records  of  the  time  show  that  as  early  as  the  year  1330  they 
became  the  holders  of  the  office  of  Hereditary  Sheriff  of  County 
Wigtown.  "  The  Sheriff  of  Wigtown"  was  the  title  of  their 
office;  yet  in  royal  proclamations  and  even  in  acts  of  Parlia- 
ment, and  always  in  familiar  intercourse,  this  official  was  ad- 
dressed as  "  Sheriff  of  Galloway,"  the  name  of  Galloway  being 
applied  to  the  counties  of  Wigtown  and  Kirkcudbright. 

This  office  formed  the  very  backbone  of  the  feudal  system; 
it  was  held  in  the  Agnew  family,  despite  all  the  various  changes 
through  the  Middle  Ages,  for  more  than  four  hundred  years, 
until  the  abolishment  of  hereditary  jurisdictions  in  Scotland,  in 
1747.  The  abolition  of  this  office — the  removal  of  the  last 
trace  of  the  government  of  the  Middle  Ages — was  the  final 
blow  struck  at  the  feudal  system.  As  a  compensation  to  the 
Agnew  family  for  the  loss  of  this  hereditary  office,  they  were 
paid  by  the  English  government  the  sum  of  .£4:000. 

The  duties  of  an  hereditary  sheriff  in  Scotland  were  far 
more  important  than  are  commonly  associated  in  these  later 
days  with  the  office  of  sheriff.  Next  to  the  king,  the  sheriff  of 
that  day  was  the  most  powerful  individual  in  the  land.  On  the 
performance  of  his  duties  rested  the  foundations  of  society ;  he 
was  law,  lawyer,  judge,  jury,  and  executioner  of  penalties.  He 
owned  allegiance  and  submission  only  to  the  king.  This  officer, 
unchecked  by  nearly  all  restraints,  was  not  as  oppressive  and 
tyrannical  as  might  be  infen'ed  from" his  powers.  In  medieval 
times  those  at  the  fountain-head  of  authority  were  the   least 


6  LIFE   OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

inclined  to  be  unjust  and  arbitrary.  It  was  the  resident  owners 
of  the  soil  who  were  the  source  of  greatest  oppression  to  the 
people. 

The  essence  of  feudalism  was,  that  superior  and  vassal  were 
alike  bound  together  by  ties  of  reciprocal  good- will.  "  Gentle- 
man's law,"  even  to  this  day,  is  regarded  respectfully  by  the 
peasants  of  Scotland.  This  absolute  power  of  the  sheriff  can  be 
estimated,  when  it  is  realized  that  even  an  earl  in  those  days 
had  not  the  power  of  shrievalty  within  his  own  earldom.  In 
ancient  times  an  appeal  lay  from  the  judgment  of  the  earl,  as 
proprietor,  to  the  court  of  the  sheriff. 

It  is  at  Lochnaw,  Stranraer,  Scotland,  that  the  Agnew 
family  holds  its  castle,  the  present  incumbent  of  the  title  being 
the  twenty-first  in  descent  from  the  first  Agnew  who  settled  there. 

Although  some  of  the  Agneaux  family  came  over  to 
England  during  the  reign  of  William  the  Conqueror,  nothing 
definite  of  their  doings  is  known.  The  first  Agneaux  of  whom 
any  authentic  record  exists  in  Great  Britain  is  that  Agneaux  de 
risle  who  took  part  in  the  conquest  of  Ulster,  in  the  reign  of 
Henry  II  of  England,  in  1171.  For  his  services  in  this  con- 
quest, he  was  allotted  the  Lordship  of  Larne,  a  beautiful  spot 
on  the  northeastern  coast  of  Ireland,  with  a  view  which  was 
terminated  only  by  the  distant  Scottish  coast.  In  commemora- 
tion of  the  expedition  in  which  they  had  gained  their  new 
possessions,  "the  sinister  hand  of  Ulster"  was  introduced  into 
their  shield.  Their  name  was  also  given  to  the  highest  moun- 
tain in  the  Antrim  range,  which  still  retains  its  appellation 
"Agnew's  Hill." 

Here  this  family  of  bold  adventurers  remained  for  more 
than  one  hundred  years,  and  the  descendants  of  the  Lord  of 
Larne  in  the  fifth  generation  were  in  quiet  possession  of  the 
land  he  had  acquired.  At  the  commencement  of  the  fourteenth 
century  the  Lord  of  Larne,  in  common  with  his  neighbors,  was 
impatient  of  the  English  yoke.  The  English  monarchs  were 
looked  upon  rather  as  feudal  superiors  than  as  kings ;  indeed, 


LINEAGE    OF   THE    AGNEW    FAMILY.  7 

they  hardly  assumed  the  latter  title  at  this  period.  The  Ulster 
lords  wished  to  assert  their  entire  independence,  and  have  a  king 
of  their  own.  Hearing  of  the  doughty  deeds  of  Edward  Bruce, 
brother  of  King  Robert  Bruce,  across  the  channel,  they  offered 
to  acknowledge  him  as  their  sovereign  if  he  would  undertake 
to  bring  them  armed  assistance  and  put  himself  at  their  head. 

The  restless  Edward  was  delighted  with  a  proposal  so  con- 
genial to  his  tastes;  and,  organizing  what  forces  he  could  in 
Galloway,  he  landed,  with  six  thousand  men,  at  Olderfieet 
Castle,  the  property  of  the  Agnews, — the  ruins  of  which  may 
still  be  seen, — on  the  Lough  of  Larne,  in  1315.  Here  the  Lord 
of  Larne  and  his  retainers  received  him  wdth  great  joy,  and 
all  the  lords  of  Ulster,  hearing  of  his  arrival,  flocked  to  his 
standard.     In  1316  Bruce  was  crowned  King  of  Ireland. 

At  this  time  the  good  King  Robert  Bruce  lived  at  Loch- 
naw,  in  the  castle  w^hich  had  been  erected  a  century  before. 
This  was  his  own  garrison,  and  there  was  no  other  fortress  as 
suitable  in  respect  to  position,  for  the  old  castle  was  considered 
impregnable,  commanding  fine  views  of  the  Firth  of  Clyde  and 
the  opposite  Irish  coast,  Agnew's  Hill  being  a  prominent  fea- 
ture in  the  background.  Robert  followed  his  brother  Edward 
to  Ireland,  and  together  they  advanced  as  far  as  Dublin.  Two 
years  later  Edward  Bruce  w^as  killed  in  battle,  the  English 
again  came  into  supremacy,  and  the  remnant  of  the  Scottish 
army  retreated  to  Scotland. 

The  Lord  of  Larne  had  been  so  seriously  compromised 
with  the  English  authorities,  by  this  connection  with  the  Bruces, 
that  we  are  not  surprised  to  learn  that  his  son  and  heir  appeared 
at  the  Scottish  court  after  the  death  of  Robert  Bruce,  when  the 
Earl  of  Moray,  his  old  commanding  officer,  was  chosen  Regent 
during  the  minority  of  King  Da^id  11.  As  a  reward  for  his 
past  services,  and  to  hold  his  allegiance  in  the  future,  the  young 
Lord  of  Larne  was  installed  in  the  keeping  of  the  office  of 
Constable  of  Lochnaw. 

The  young  constable  showing  bravery  and  spirit, — qualities 


8  LIFE    OF    D.    HATES   AGNEW,    M.D.,    LL.D. 

necessary  for  an  officer  holding  the  kmg's  commission  among 
the  wild  Scots  of  Galloway, — was  soon  afterward  appointed 
Sheriff  of  Wigtown.  The  sheriffship  is  described  as  an  heredi- 
tary gift,  but  the  successions  were  not  preserved  at  this  time; 
for  the  Earl  Douglas,  in  a  later  generation,  forcibly  denuded  the 
Agnews  of  their  office  for  some  years.  Hence  the  appointment 
of  the  first  three  sheriffs  is  regarded  as  personal ;  the  office 
of  Hereditary  Sheriff  of  Wigtown  being  given  again  to  the 
Agnews  in  a  new  charter,  in  1452.  It  was  only  this  latter 
commission  which  was  recognized  by  the  English  government. 

This  is  the  historical  story  of  the  first  settlement  of  the 
Agnews  in  Scotland ;  but  the  traditionary  account,  which  is 
fully  believed  by  the  oldest  inhabitants,  points  to  a  much  bolder 
course,  by  which  the  Lord  of  Larne  obtained  a  footing  here. 

According  to  this  tradition  among  the  peasantry  of  Wig- 
town, a  member  of  the  Agnew  family  once  found  himself  in 
Galloway,  and  here  he  determined  to  stay ;  and,  courting 
adventure  in  the  true  Norman  spirit,  he  cast  his  eyes  about 
him  for  a  well-housed  foe.  The  king's  Castle  of  Lochnaw,  ac- 
cording to  our  informants,  had  been  captured  by  one  M'Ciellan, 
a  chief  of  the  native  race  ;  and  here,  strongly  posted  in  the  fortress, 
he  set  the  royal  authority  at  defiance.  The  castle  was  quite  to 
young  Agnew's  taste,  and  he  immediately  besieged  it,  with  the 
full  approbation  of  the  king. 

M'Ciellan  was  well  armed  and  provisioned,  and  Agnew, 
with  a  small  band  of  followers,  could  make  no  impression ;  hence, 
storming  the  castle  was  out  of  the  question,  and  he  was  com- 
pelled to  resort  to  strategy.  It  must  be  understood  that  the 
castle  stood  on  an  island,  and,  with  the  exception  of  a  narrow 
rock  at  either  end,  the  ground  was  entirely  covered  with  the 
buildings  of  this  fortress. 

Agnew  withdrew  the  besieging  party  from  sight,  and  it  was 
settled  that  his  right-hand  man  should  be  hanged  on  a  tree, 
the  rope  being  so  arranged  that  the  victim  could  himself  pre- 
vent strangulation.     The  hanging  scene  was  duly  enacted,  and 


LINEAGE   OF    THE    AGNEW   FAMILY.  9 

the  executioners  retired.  The  plot  succeeded  to  their  hearts' 
content.  M'Clellan  had  watched  their  stranj^e  doings,  and  no 
sooner  saw  them  off  than,  manning  a  boat,  he  rowed  to  the  shore 
to  see  what  had  been  done.  No  sooner  had  he  landed  than  out 
rushed  the  besiegers  from  an  ambush.  M'Clellan's  retreat  to  the 
island  was  instantly  cut  off;  but  he  and  liis  band  fought  their 
way  out  of  the  inclosure.  Agnew  followed  him,  and,  when 
they  reached  the  site  of  the  Brig  O'Doon,  he  succeeded  in  dis- 
patching the  old  chieftain.  Now,  in  the  moment  of  triumph, 
he  remembered,  for  the  first  time,  his  poor,  half-hung  lieutenant. 
When  he  arrived  again  on  the  shores  of  the  white  Loch  of 
Lochnaw,  there  the  poor  decoy  hung,  stiff  and  cold. 

On  the  death  of  the  Bruces  a  civil  war  broke  out,  and  in 
13-4:7  David  II  was  taken  prisoner  by  the  English,  and  the 
Sheriff  ot  Wigtown  would  have  been  destroyed  had  not  Sir 
William  Douglas  come  to  his  relief.  A  story  of  ravage  and 
confiscation  follows  this  event, — for  a  century  the  country  was 
unfilled,  the  woods  were  wasted,  and  the  forester's  art  was 
utterly  neglected.  •  i: 

The  Douglases  had  always  been  friendly  to  the  Agnews, 
but  in  1390,  Black  Douglas,  a  natural  son  of  the  famous  Earl 
Douglas,  rose  into  power.  He  determined  to  reduce  all  the 
Scottish  barons  to  a  state  of  vassalage.  The  Constable  of 
Lochnaw  could  offer  no  serious  resistance  to  the  forces  of  the 
earl,  who  besieged  the  Castle  of  Lochnaw.  Eventually  the 
Agnews  were  driven  from  Scotland,  and  sorrowfully  the  Laird 
of  Lochnaw,  the  great-grandson  of  the  first  proprietor,  sailed, 
with  his  family  and  retainers,  across  the  channel  to  the  Bay 
of  Larne.  In  the  words  of  Sir  George  Mackenzie,  a  chronicler 
of  the  period,  "the  Castell  of  Lochnaw  was  blowen  up."  This 
act  of  Black  Douglas  was  extremely  bold,  for  the  castle  was 
still  the  property  of  the  king. 

The  ex-Constable  of  Lochnaw  found  Ireland  little  to  his 
liking,  and  repaired  shortly  to  the  Scottish  court  at  Perth,  where 
he  received  from  the  aged  monarch,  Robert  III,  much  commis- 


10  LIFE   OF    D.    HATES   AGNEW,    M.D.,    LL.D 

eration,  but  no  assistance.  He  became  a  member  of  the  royal 
household,  and  stood  m  high  favor.  While  at  court  the  young 
Agnew  had  the  good  fortune  to  attract  the  favorable  notice 
of  Princess  Margaret,  who  was  married  to  Archibald,  son  of 
Black  Douglas.  Although  not  inclined  to  love  the  name  of 
Douglas,  yet  he  soon  had  cause  to  be  grateful  for  her  good 
offices.  On  the  death  of  her  husband,  she  received  from  her 
brother,  King  James  I,  the  lordship  of  Galloway,  and  she  took 
up  her  residence  with  feudal  pomp  at  the  old  Castle  of  Threave. 
Here  she  was  accompanied  by  her  young  protege,  Andrew 
Agnew. 

Through  her  efforts  Andrew  Agnew  was  restored  to  the 
possessions  of  his  fathers,  in  1426,  on  his  marriage  to  Princess 
Mary,  the  niece  of  his  liege  lady. 

The  old  castle  had  been  destroyed  by  Black  Douglas,  and 
the  constable  set  bravely  to  work  to  build  a  better  home  for 
himself  and  his  gentle  bride.  On  the  south  shore  of  the  Loch 
of  Lochnaw  he  built  a  castle,  a  greater  part  of  which  stands  to 
the  present  day,  which,  as  has  been  said,  is  still  owned  by  the 
Agnews,  his  lineal  descendants. 

In  a  "  History  of  the  Hereditary  Sheriffs  of  Galloway,"  by 
Sir  Andrew  Agnew,  Bart.,  M.P.,  there  is  a  fine  picture  of  Scot- 
tish life  from  the  year  1170  to  1747.  Sir  Andrew  Agnew  has 
compiled  this  book  from  the  archives  of  the  Agnew  family, 
including  sasines,  infeftments.  summonses,  discharges,  letters 
of  horning,  inhibitions,  informations,  bonds,  precepts  of  clare- 
constat,  marriage  contracts,  reliefs,  wills,  tacks,  commissions, 
rentals,  acts  of  Parliament,  processes  and  all  sorts  of  papers 
connected  with  the  proceedings  of  the  Sheriff  Courts ;  memo- 
randa, charters  under  the  Great  Seal,  and  charters  from  bishops, 
abbots,  and  commendators.  In  this  Avay  the  actual  picture  of 
Scottish  life  throughout  this  period  has  been  depicted ;  the  cus- 
toms, the  dresses,  the  value  of  money,  the  price  of  the  neces- 
saries of  life,  the  food  eaten,  table  manners,  the  rentals  paid  and 
received,  and  all  the  minutiae  of  Scottish  life  have  been  drawn, 


LINEAGE    OF    THE    AGNEW   FAMILY.  11 

making  the  book  an  invaluable  treasure-house  for  the  antiqua- 
rian or  the  novelist,  especially  as  the  greater  part  of  this  matter 
has  never  been  published  in  any  other  form. 

Patrick  Agnew,  the  fourth  hereditary  sheriff,  may  be  taken 
as  a  fair  type  of  a  Scottish  hereditary  official  in  1500.  As  to 
law,  he  troubled  himself  little  with  studying  the  statutes.  Cus- 
tom was  law  to  him,  and  he  was  not  scrupulous  in  enforcing 
his  supposed  rights,  in  defiance  of  any  acts  of  Parliament  to 
the  contrary.  If  an  injury  was  to  be  redressed  or  a  friend  to 
be  assisted,  he  sprang  into  his  saddle  and  dealt  out  justice  with 
his  own  good  sword,  caring  little  for  the  technicalities;  if 
attacked,  he  was  ready  to  defend  himself;  if  his  cattle  were 
carried  off,  he  was  quite  capable  of  returning  the  compliment 
Avith  interest.  Such  assertions  of  the  dignity  of  his  office  he, 
doubtless,  considered  necessary  to  sustain  the  traditionary  status 
of  a  Galloway  sheriff. 

Through  Margaret  Kennedy,  tlie  wife  of  Sir  Patrick  Ag- 
new, the  eighth  hereditary  sheriff,  the  Agnews  have  a  double 
royal  descent, — on  one  side  from  King  James  II  of  Scotland, 
and  on  the  other  from  King  Henry  VII  of  England. 

Sir  Andrew  Agnew,  the  twelfth  and  last  hereditary  sheriff, 
was  a  famous  soldier,  but  not  a  practical  agriculturist.  On  the 
death  of  his  father,  when  the  paternal  estates  fell  into  his 
possession,  he  determined  to  acquaint  himself  with  the  routine 
of  farming  operations.  One  of  his  attempts  at  such  superin- 
tendence is  the  subject  of  a  favorite  Galloway  story,  which  is 
still  extant : — 

"Sir  Andrew,  though  a  grand  soldier,  was  nae  farmer  ava'; 
he  kent  naething  aboot  it.  A'  the  castle  flirm-wark  in  his  days, 
an'  lang  before  and  after,  was  done  by  baillie  wark.  There  was 
baillie  pleuching,  baillie  harrowing,  baillie  shearing,  baillie  corn- 
leading, — aye,  an'  peat-leading,  too !  The  tenants  were  a'  warned 
in  their  turn  to  do  as  they  were  bun'  in  their  tacks. 

"  Sir  Andrew  was  new  come  hame ;  they  had  been  a' 
warned  in,  and  were  shearing  ower  in  the  Beef-Park,  an',  as 


12  LIFE   OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

was  aye  the  case  when  p.  wheen  o'  farmers  met,  they  had  great 
fetrivmgs  wha  wad  be  first  oot  at  the  lan's  end.  Horrid  bad 
wark  they  made  it,  and  whiles  left  as  muckle  as  they  took. 

"Just  as  the  sheriff  came  oot  to  see,  they  were  kemping  ^ 
a'  they  could,  and  the  grieve,  afeared  the  sheriff  wad  be  angry, 
began  and  trod  doon  the  lang  stubbles  wi'  his  feet,  and  made 
a  show  o'  gathering  as  muckle  o'  the  left  corn  as  he  could. 

" '  AVhat's  that  ye're  doing  there  1 '  says  Sir  Andrew, 
sharply. 

'"Oh,  please  your  honour,'  answers  the  grieve,  terribly 
frightened;  'oh,  I'm  just  tramping  doon  a  lot  o'  the  o'erplus. 
There's  plenty  to  tak'  and  plenty  to  leave  here,  please  your 
honour.  It's  just  to  keep  the  grun'  warm,  your  honour,  for  I 
expect  a  right  guid  awal  crap  here  next  year ' ;  and  so  he  ran 
on,  scarce  knowing  what  he  said." 

Greatly  astonislied  was  the  grieve  to  find  that  his  ridiculous 
invention  was  taken  in  good  faith;  but  if  he  felt  little  com- 
punction at  thus  shamefully  imposing  upon  his  master,  his 
deceit  drew  upon  him  a  retribution  as  sharp  as  it  was  unex- 
pected ;  for  the  sheriff,  greatly  pleased  with  the  tlieory  of  keep- 
ing the  ground  warm,  "  keepit  him  there  a'  the  morning,  aye 
treading  doon  the  stubble,  and  whiles  he  wad  begin  and  tread 
doon  the  corn  himsel'."  So  the  unjust  steward  cut  a  very 
sorry  figure  in  the  eyes  of  his  own  men.  "  Ye  see,"  as  is  a 
usual  remark  after  some  similar  stories,  "  although  Sir  Andrew 
was  a  bra'  warrior,  he  didna  ken  the  lea-side  o'  a  rick ! " 

This  Sir  Andrew  Agnew,  on  account  of  his  daring  military 
exploits  and  quaint  humor,  has  become  a  famous  figure  in 
Scotch  history.  In  his  defense  of  Blair  Castle  from  the  attack 
of  the  rebels,  in  tlie  spring  of  1745,  Sir  Andrew  was  the  hero- 
of  a  number  of  characteristic  incidents,  which  have  been  de- 
scribed by  Sir  Walter  Scott  in  his  "  History  of  Scotland."    The 

^  Kemping  is  an  expression  commonly  applied  to  reapers  trying  to  see  who  will  cut 
most  quickly  their  share  of  corn  in  the  harvest-field.  While  the  term  strictly  signifies- 
rivalry,  it  implies  undue  haste,  and  that  the  work  is  hurriedly  and  badly  done. 


LINEAGE    OF    THE    AGXEW    FAMILY.  13 

fame  of  Sir  Andrew  was  already  considerable,  and  the  treat- 
ment which  the  rebels  experienced  at  his  hands  went  far  to 
increase  this  reputation. 

The  rebels  besieged  this  castle  for  a  fortniglit,  during 
which  time  the  sheriff  showed  himself  too  good  a  soldier  to 
abandon  his  post, — although  his  men  were  in  a  state  of  semi- 
starvation, — and  he  was  too  old  an  one  to  be  provoked  into  a 
sally.  He  knew  that  each  day  he  could  detain  so  large  a  force 
of  rebels  before  Blair  Castle  would  be  of  the  greatest  advantage 
to  the  king ;  and  here  he  determined  to  stay  as  long  as  a  single 
mouthful  of  biscuit  remained  in  store. 

Time,  however,  hung  very  heavily  the  while  on  the  hands 
of  the  younger  officers,  who,  in  default  of  all  other  sources  of 
diversion,  at  last  bethought  themselves  of  a  joke  at  the  expense 
of  their  commander.  As  a  part  of  the  plot,  they  purloined  a 
portion  of  the  great  man's  wardrobe, — taking  a  full  suit  of  the 
brigadier's  uniform, — with  which,  with  the  assistance  of  some 
straw,  they  soon  produced  an  excellent  imitation  of  his  figure. 
Then  they  placed  the  stuffed  sheriff  at  a  window  of  the  tower, 
with  a  spy-glass  in  his  hand,  in  the  attitude  of  reconnoitering 
the  rebels. 

"  This  apparition,"  says  Sir  Walter  Scott,  "  did  not  escape 
the  hawks'  eyes  of  the  Highlanders,  who  commenced  to  pour 
their  fire  upon  the  turret-window,  without  producing  any  ade- 
quate result.  The  best  deer-stalkers  of  Athole  and  Badenoch 
persevered,  nevertheless,  and  wasted  their  ammunition  in  vain 
upon  this  impassible  commander.  At  length.  Sir  Andrew  him- 
self became  anxious  to  know  what  could  possibly  induce  so 
constant  a  fire  upon  that  particular  point ;  and  ascending  the 
turret  himself,  there  he  saw  his  other  identity  standing  under 
fire, — as  stiff,  as  fearless,  as  imperturbable  as  himself  The 
sheriff  was  scandalized  at  the  irreverent  deception,  and,  discov- 
ering the  author  of  the  plot,  he  delivered  sentence  upon  the 
culprit  to  this  effect : — 

'"Let  the  loon  that  set  it  up  just  go  up  himsel'  and  tak'  it 


14  LIFE    OF   D.    HAYES    AGNEW,    M.D.,    LL.D. 

doon  again.'  A  great  effect  had  been  produced,  however,  upon 
the  rebels,  and  the  clansmen,  ah*eady  predisposed  to  regard  the 
sheriff  with  superstitious  awe,  had  found  their  surmises  as  to 
his  invulnerability  so  thoroughly  confirmed  that  henceforth  they 
became  hopeless  of  success." 

A  few  days  later,  the  sheriff  was  relieved  from  his  unen- 
viable position  by  the  appearance  of  the  king's  Black  Horse. 

A  camp-story,  in  which  Sir  Andrew  did  not  come  out 
victor,  has  been  preserved  of  these  days,  to  understand  which 
it  is  necessary  to  bear  in  mind  that,  in  the  Lowlands  of  Scot- 
land, a  "Lammermuir  lion"  is  a  proverbial  expression  for  a 
sheep. 

After  the  affair  at  Ostend,  in  which  Sir  Andrew  Agnew 
distinguished  himself,  when  the  English  were  at  war  with  the 
French,  the  officers  of  the  garri-son  were  talking  over  the  inci- 
dents of  the  siege  at  the  dinner-table,  and,  becoming  very  noisy 
as  they  fought  their  battles  over  again,  some  of  the  younger 
ones  became  very  eloquent  on  their  own  prowess,  until  the 
Commandant,  Sir  Andrew  Agnew,  becoming  tired,  thought  it 
time  to  give  them  a  hint.  Behind  his  chair  stood  a  faithful 
servant,  a  Lammermoor  man,  almost  as  great  a  character  as  his 
master,  who  had  followed  Sir  Andrew  closely  in  many  a  field. 
"John,"  said  the  sheriff,  slyly,  "  I  think  I  looked  as  bold  a  man 
yesterday  as  any  in  the  brigade ;  what  do  you  say,  my  man? " 
"  Aye,  Sir  Andrew,"  answered  the  batman,  with  a  twinkle  in 
his  eye,  "  you  looked  for  all  the  world  just  like  a  lion  !  "  An 
uproarious  burst  of  merriment  greeted  this  response,  in  which 
the  sheriff  heartily  joined,  supposing  it  was  due  to  his  own  wit 
at  the  expense  of  his  officers.  The  tables,  however,  were  soon 
turned ;  for,  as  he  good-humoredly  continued,  "And  wherever 
did  you  see  a  lion,  you  scoundreH  "  a  jolly  young  subaltern 
interposed,  "  Oh,  sir  !  there's  plenty  of  lions  in  John's  country  ; 
surely  you  know  John's  slain  many  a  Lammermuir  lion!" 

The  General  James  Agnew  who  was  killed  at  the  Battle 
of  Germantown,  Philadelphia,  was  a  nephew  of  this  sheriffs 


LINEAGE    OF    THE    AGNEW   FAMILY.  15 

In  1775  he  was  made  Aide-de-camp  to  tlie  king,  with  the  rank 
of  Colonel,  being  made  Brigadier-General  the  following  year. 
The  description  given  of  his  death  in  Holmes'  "  Annals  of 
America  "  and  in  the  "  Pictorial  History  of  England  "  is  incorrect. 
The  correct  account  is  given  on  anotlier  page  of  tliis  biography. 

This  sheriff's  sayings  and  doings  have  been  the  subject  of 
innumerable  traditions ;  "  to  give  one  of  Sir  Andrew  Ar/neiv^s 
broad  Jiiiifs^'  has  been  a  proverbial  expression  in  Scotland  for 
the  last  hundred  years,  the  force  of  which  is  exemplified  by  a 
story  from  a  book  of  Scotch  humor,  published  toward  the  close 
of  the  last  century  : — 

"  Sir  Andrew  Agnew,  of  Lochnaw,  a  well-known  Scotch 
baronet,  was  famous  for  giving  what  he  called  '  broad  hints.' 
Having  been  long  pestered  by  an  impertinent  intruder,  it  was 
one  day  remarked  to  the  baronet  that  he  was  fortunate  in  hav- 
ing freed  himself  of  the  bore,  and  he  was  asked  how  he  had 
contrived  it.  '  Ah  ! '  he  replied,  '  I  was  obliged  to  give  the  loon 
a  broad  hint.''  '  A  broad  hint ! '  said  the  friend ;  '  why,  I 
thought  he  was  one  of  those  who  would  never  take  any  hint ! ' 
'  By  my  faith,'  rejoined  Sir  Andrew,  '  but  he  was  forced  to  take 
it;  for,  as  the  chiel  wouldna  gang  oot  at  the  door,  I  just  threw 
him  oot  at  the  window.'  " 

He  had  been  bred  in  the  true  old  British  prejudice  against 
the  French,  and,  although  he  had  served  often  upon  French 
soil,  he  hated  the  language,  and  disdained  to  learn  a  word  of  it. 
Once,  Avhen  on  a  visit  to  his  daughter.  Lady  Bruce,  being  at 
church,  the  minister,  in  his  discourse,  objected  to  the  authorized 
translation  of  the  text  upon  which  he  was  preaching,  and  gave 
an  amended  version,  in  enforcing  the  superiority  of  which  he 
proceeded  to  say :  "  The  Avords  in  the  original  Hebrew  are 
these :  Comment  vous  portez  vous.'"  The  sheriff's  wrath  was 
raised  to  boiling-pitch ;  not  only  had  an  insult  been  offered  to 
his  understanding,  but  his  peculiar  antipathy  had  been  aroused. 
He  started  from  his  seat,  and  it  was  with  difficulty  that  he 
was  persuaded  by  his  daughter  to  sit  still.    No  sooner,  howeveiv 


16  LIFE    or   D.    HAYES    AGNEW,    M.D.,    LL.D. 

was  the  service  over,  than  his  righteous  indignation  was  brought 
out  before  all  the  congregation.  "The  scoundrel !"  he  said; 
"  and  yet,  I  could  liave  forgiven  him  had  he  not  used  the  only 
French  I  ever  knew." 

Following  the  rebellion  in  Scotland  in  1746,  the  British 
government,  alarmed  by  its  extent,  were  naturally  anxious  to 
increase  the  influence  of  the  Crown  in  Scotland;  the  great  bar- 
rier to  the  accomplishment  of  this  purpose  was  the  hereditable 
jurisdictions  held  by  the  barons  and  chieftains. 

As  these  hereditary  rights  had  been  expressly  reserved  at 
the  time  of  the  union  of  England  and  Scotland,  it  was  feared 
that  their  abolition  would  breed  fresh  dissatisfaction ;  but  after 
a  fierce  battle  over  the  subject  in  Parliament,  a  bill  was  passed 
abolishing  hereditable  jurisdictions  and  making  arrangements 
for  compensation  to  their  owners. 

It  was  found  that  in  only  sixteen  cases  the  claims  of  hered- 
itary sheriffs  could  be  proved,  viz.,  those  of  the  shires  of  Argyle, 
Bute,  Caithness,  Clackmannan,  Cromarty,  Dumfries,  Dumbar- 
ton, Elgin,  Fife,  Kinross,  Kirkcudbright,  Nairn,  Orkney  and 
Zetland,  Peebles,  Selkirk,  and  Wigtown. 

In  only  four  families  had  the  sheriff'ships  of  their  respective 
counties  been  continuous  since  1567.     These  were: — 

The  Earls  and  Dukes  of  Argyle,  .  .  Tarbert  and  Argyle. 

The  Earls  of  Rothes,       .         .  .  .  Fife. 

The  Murrays  of  Philiphaugh,  .  .  .  Selkirk. 

The  Agnews  of  Lochnaw,         .  .  .  Wigtown. 

Of  these,  the  Duke  of  Argyle's  commission  was  dated  Feb- 
ruary 26,  1473  ;  the  Earl  of  Rothes',  June  1,  1529 ;  the  Mur- 
ray's is  unknown;  while  the  Agnew's  was  dated  1452,  making 
it  the  oldest  in  Scotland,  although,  as  has  been  shown,  the 
Agnews  held  the  office  for  over  a  century  before  that  date. 
The  Sheriff"  of  Wigtown  claimed  less  proportionally  than  any 
of  the  other  office-holders,  and  received  £4:111  6s.,  being 
nearly  six  times  as  much  as  all  of  the  rest  collectively,  showing 
that  his  office  was  considered  of  the  greatest  importance. 


LINEAGE    OF    THE    AGNEW   FAMILY.  17 

Thus  ended  the  days  of  hereditable  jurisdictions  in  Scot- 
land. No  rational  person  can  now  doubt  that  the  change  \yas 
a  wise  one,  although  this  conviction  grew  only  gradually  upon 
the  people. 

This  Scottish  branch,  which  had  long  lield  the  title  of 
Knight,  were  given  a  baronetage  on  July  28,  1629,  by  Charles  I. 
The  circumstances  under  which  the  Agnew  family  received 
its  baronetage  forms  an  interesting  page  in  English  history. 
This  title  w^as  not  regarded  by  the  Agnew  family  at  the 
time  as  conferring  any  special  dignity  to  their  position,  and 
they  preferred  the  title  of  "Sheriff"  to  that  of  "Sir."  Different 
members  of  the  family  had  been  knighted  many  times  by  differ- 
ent sovereigns,  but  they  had  not  used  their  titles.  It  was  not 
until  later  years  that  this  title  grew  into  greater  prominence. 

The  title  of  baronet  is  of  comparatively  recent  origin, 
having  been  revived  by  King  James  I,  who  constituted  it  an 
hereditary  dignity.  The  term  "  baronet  "  was  originally  given 
to  a  class  of  bannarets,  who  were  hereditary  barons  of  Parlia- 
ment. The  existing  baronetage  of  England  dates  from  1611,  in 
which  year  James  I  established  it  by  letters  patent  under  the 
Great  Seal;  in  1619  he  further  extended  the  order  to  Ireland, 
and  in  1624  adopted  steps  to  create  a  Scottish  branch,  which 
intention  was  carried  out,  in  1625,  by  his  son  Charles  I. 

Every  person  who  sought  the  dignity  of  a  baronet  was  com- 
pelled to  give  proof  that  he  was  a  gentleman  of  blood, — i.e.,  de- 
scended on  his  father's  side  from  a  grandfather  who  bore  arms, 
possessed  of  a  good  reputation,  and  had  an  annual  revenue  of 
not  less  than  ^£1000. 

These  baronets,  in  turn  for  the  honor  granted  them  by  their 
government,  were  expected  to  help  in  return  in  maintaining 
armies  in  different  localities.  Thus,  the  baronets  of  Ulster 
assisted  the  government  in  its  management  of  affairs  in  Ireland; 
the  baronets  of  Nova  Scotia,  among  whom  were  the  Agnews, 
rendered  great  aid  in  colonizing  that  recently-explored  region. 
These  latter  baronets  were  granted  special  honors  by  Charles  I, 


18  LIFE    OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

being  permitted  to  wear  around  the  neck  "  an  orange  taunie 

silk  ribbon,  whereon  shall  be  pendent  in  a  scutcheon  argent,  a 

saltier  azure,  thereon  an  inescutcheon  of  the  armes  of  Scotland, 

with  an  imperial  crown  above  the  scutcheon,  and  encircled  with 

this  motto  : — - 

"  Fax  mentis  honestse  glorise." 

The  Hereditary  Sheriffs  of  Galloway  from  1452  to  1629 
were  as  follow :  Andrew,  Andrew,  Quentin,  Patrick,  Andrew, 
Patrick  (who  was  the  first  of  his  race  to  be  buried  as  a  Protest- 
ant, in  1590),  Andrew,  and  Patrick  Agnew. 

It  was  this  last  Sir  Patrick  Agnew,  Knt.,  who  was  created 
a  Baronet  of  Nova  Scotia  on  July  28,  1629,  by  Charles  I.  He 
married  Margaret,  daughter  of  Sir  Thomas  Kennedy,  and  died 
in  1661.  His  son.  Sir  Andrew  Agnew,  M.P.  for  Wigtownshire, 
was  appointed,  on  the  suppression  of  hereditable  jurisdictions, 
by  Cromwell,  in  1656,  Sheriff  of  all  Galloway,  and  a  member  of 
the  Commission  for  governing  the  Kingdom  of  Scotland.  At 
the  restoration  of  Charles  II,  he  was  re-instated  in  his  heredi- 
tary sheriffalty,  in  1661.  Sir  Andrew  married  Lady  Anne 
Stewart,  daughter  of  Alexander,  Earl  of  Galloway,  and  died 
in  1671.  His  son  and  heir,  also  named  Sir  Andrew  Agnew,  on 
refusing  the  test  oath  of  1682,  was  ejected,  by  the  Privy  Council 
of  Scotland,  from  his  office,  but  was  re-instated  at  the  restora- 
tion, in  1689,  by  the  Convention  of  Estates,  of  which  he  was  a 
member.  He  married  Jane,  daughter  of  Sir  Thomas  Hay, 
Baronet  of  Park,  and  died  in  1701.  His  son,  the  fourth 
baronet,  Sir  James  Agnew,  married  Lady  Mary  Montgomerie, 
daughter  of  Alexander,  Earl  of  Eglinton.  He  is  particularly 
famous  in  history  for  being  the  father  of  twenty-one  children. 

The  fifth  baronet,  Sir  Andrew  Agnew,  was  the  distin- 
guished military  officer  of  whom  we  have  already  read,  being 
a  Lieutenant-General  in  the  English  army.  During  his  life- 
time, hereditary  jurisdictions  were  abolished  finally  in  Scot- 
land. He  had  married  his  cousin,  Eleanor,  the  only  daughter 
of  Thomas  Agnew,  Esq.,  and  was  also  remarkable  in  being 


The  Agnew  Coat  of  Arms. 


LINEAGE    OF    THE   AGNEW   FAMILY.  19 

the  father  of  eighteen  children.  He  died  in  1771,  at  the  ad- 
vanced age  of  8-1  years,  being  succeeded  by  his  fifth  but  eldest 
surviving  son.  Sir  Stair  Agnew,  his  son,  sixth  baronet,  married 
Mary,  daughter  of  Thomas  Baillie,  Esq.  On  account  of  the 
death  of  his  eldest  son,  Andrew,  who  had  married  Martha  De 
Courcy,  eldest  daughter  of  John,  twenty-sixth  Lord  of  Kinsale, 
he  was  succeeded  by  his  grandson,  Andrew,  a  posthumous  child. 
The  seventh  baronet,  Sir  Andrew  Agnew,  married  Madeline, 
daughter  of  the  late  Sir  David  Carnegie,  and  died  in  1849. 
He  was  succeeded  by  Sir  Andrew  Agnew,  who  married  Lady 
Louisa  Noel,  daughter  of  Charles,  Earl  of  Gainsborough.  The 
life  of  this  baronet  forms  a  remarkable  coincidence  with  the 
head  of  the  American  branch  of  the  Agnew  family,  for  he  was 
bom  in  1818,  the  same  year  as  Dr.  D.  Hayes  Agnew,  and  died 
March  25,  1892,  three  days  after  Dr.  Agnew's  death. 

The  present  incumbent  of  the  title,  Sir  Andrew  Noel  Ag- 
new, was  born  in  1850.  He  married  Gertrude,  daughter  of  the 
Hon.  Gowran  Charles  Vernon. 

The  coat  of  arms  of  the  Agnew  family  is  as  follows : — 

Arms,  argent,  a  chevron  between  two  cinqiiefoils  in  chief,  gules, 

and  a  saltier  couped  in  base,  azure. 
Crest,  an  eagle  issuant  and  regardant,  proper. 
Supporters,  two  heraldic  tigers,  proper,  collared  and  chained,  or. 
Motto,  "  Consilio,  non  impetu," — by  persuasion,  rather  than  by 

force. 
Seat,  Lochnaw  Castle,  Stranraer,  Wigtownshire. 
Anciently  the  coat  of  arms  was  azure,  three  lambs  passant,  argent, 

with  the  motto  "  Agnus  Miles." 

Of  those  members  of  the  Agnew  family  who  migrated  to 
America  from  the  North  of  Ireland  the  greater  number  came 
originally  from  Scotland,  becoming  members  of  that  brave,  hardy, 
persevering,  and  Godly  race,  the  Scotch-Irish.  The  earls  of 
Tyrone  and  Tyrconnel,  in  the  Province  of  Ulster,  having  con- 
spired against  the  government,  in  the  reign  of  James  I,  fled 
from  the  kingdom  to  escape  punishment.  Some  of  their 
accomplices  were  arrested,  condemned,  and  executed,  but  the 


20  LIFE   OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

two  earls  were  attainted  by  the  process  of  outlawry,  upon 
which  their  vast  estates,  containing  about  five  hundred  thou- 
sand acres  of  land,  were  escheated  to  the  crown.  King  James 
resolved,  if  possible,  to  improve  a  country  which  was  covered 
by  forests,  desolated  by  war,  infested  by  robbers,  or  inhabited 
by  ignorant  natives.  For  this  purpose  he  divided  the  escheated 
lands  into  small  tracts,  and  these  he  gave  to  colonists,  who  were 
to  settle  them  within  four  years  with  a  certain  number  of  sub- 
tenants. 

According  to  his  command,  in  1610,  the  preference  was 
given,  in  distributing  the  lands,  to  the  inhabitants  of  the  west 
of  Scotland,  as  they  were  Protestants  from  his  own  country  and 
were  industrious  people.  The  passage  by  water  being  very 
short,  they  could  with  greater  ease  settle  the  land  according  to 
their  contracts.  The  establishment  of  prelacy  in  Scotland  in 
the  year  1637  and  afterward  in  the  year  1661,  among  people 
who  had  adopted  the  simpler  form  of  Presbyterian  worship, 
became  additional  cause  of  the  numerous  emigrations  from  that 
kingdom  to  the  North  of  Ireland. 

The  superior  knowledge,  industry,  and  temperance  of  the 
Scotch  in  a  short  time  enabled  them  to  supplant  the  natives 
among  whom  they  lived,  and  six  of  the  northern  counties,  by 
the  end  of  the  seventeenth  century,  were  inhabited  chiefly  by 
the  descendants  of  Scottish  families  or  the  remnants  of  Crom- 
well's army.  Their  faithful  services  and  uniform  attachment  to 
government  had  placed  them  in  the  ranks  of  good  and  faithful 
subjects,  and  their  unshaken  loyalty  had  entitled  them  to  con- 
fidence and  public  favor;  but  they  were  treated  like  aliens 
and  strangers  by  Charles  II  and  James  II,  with  marks  of  dis- 
trust for  their  civil  capacity,  and  depressed  in  their  religious 
observances  by  the  spirit  of  intolerance,  because  they  were  not 
of  the  established  Church  of  Ireland.  Men  who  were  thus  de- 
graded and  vexed  by  burdens  and  slights  emigrated  in  thousands 
to  Pennsylvania,  where  they  knew  the  principles  of  civil  and 
religious  liberty  had  their  full  operation. 


LINEAGE    OF   THE    AGNEW    FAMILY.  21 

Among  this  rare  people  stood  prominently  the  Agnews. 
This  class  of  people,  who  had  reclaimed  the  desolated  lands  of 
Ulster,  who  had  built  towns  and  established  manufactories, 
were  Presbyterians ;  and  neither  the  tyranny  of  Charles  II  nor 
James  II,  the  dragoons  of  Claverhouse  nor  the  intimidations 
of  the  Papacy,  could  compel  them  to  surrender  their  independ- 
ence or  give  up  their  religion.  These  were  the  people  who  had 
made  famous  the  glens  and  moors  of  Scotland  and  Ireland,  and 
who,  rather  than  yield  their  convictions  of  faith  and  duty,  suf- 
fered the  sharpest  persecutions,  coming  eventually  to  this  side 
of  the  Atlantic  Ocean  to  find  homes  more  congenial  to  their 
taste.  Men  of  strong  intellect,  independent  thinkers,  intolerant 
of  oppression,  gentle  in  peace,  but  terrible  in  war,  they  have 
left  their  impress  upon  all  the  institutions  of  the  country  of 
their  adoption. 

The  bold  position  of  County  Wigtown,  and  the  fact  that 
the  family  were  engaged  in  the  colonization  of  one  of  the 
largest  and  most  important  of  the  American  colonies,  also 
naturally  attracted  the  attention  of  the  members  of  the  family 
to  America.  In  consequence,  in  the  early  part  of  the  history 
of  this  country  the  Agnews  became  prominent.  In  the  early 
part  of  the  eighteenth  century,  three  brothers  of  this  family 
came  to  the  then  British  colonies.  One  brother  settled  in  New 
Jersey,  another  in  Pennsylvania,  and  the  third  in  South  Carolina. 
The  name  of  the  brother  who  settled  in  South  Carolina  was 
Samuel.  His  descendants  are  still  in  existence  in  the  South,  a 
number  of  the  family  living  in  Mississippi,  forming  the  branch 
of  the  "  Southern  Agnews."  During  the  Revolution,  the  mem- 
bers of  this  branch  of  the  family  were  Tories,  and  suffered,  in 
consequence,  many  losses  and  privations.  All  traces  have  been 
lost  of  the  brother  who  settled  in  New  Jersey,  even  to  his  name ; 
probably  this  branch  of  the  family  has  become  extinct. 

It  is  with  the  third  brother,  who  settled  in  Pennsylvania, — 
James  Agnew, — that  interest  centres  for  the  readers  of  this  biog- 
raphy, for  he  was  the  great-grandfather  of  David  Hayes  Agnew. 


22  LIFE   OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

Settlements  were  made  on  Octorara  Creek  by  the  Scotch  and 
Irish  colonists  about  1717,  and  later  throughout  other  portions 
of  Lancaster  and  Bucks  Counties.  About  1737,  many  of  the 
Agnew  family  settled  in  the  northwestern  part  of  York  (now 
Adams)  County,  on  Tom's  and  Marsh  Creeks. 

In  the  quaint,  old,  deserted  burying-ground  at  Gettysburg, 
which  is  now  completely  overshadowed  by  that  greater  grave- 
yard which  marks  the  high-water  mark  of  rebellion,  lie  a 
number  of  the  earlier  members  of  the  Agnew  family  in  this 
country.  In  this  quaint  old  burying-ground  on  Black's  turn- 
pike, a  mile  and  a  half  out  of  the  village  of  Gettysburg,  there 
are  a  number  of  grave-stones  sacred  to  the  memory  of  many 
of  the  Agnew  family.  On  one  stone  there  is  a  rude  carving 
of  weights  and  measures,  with  the  further  inscription :  "  The 
Weights  and  Measures  of  Scotland."  On  another  is  the  coat 
of  arms  of  the  Agnews  of  Lochnaw. 

Dr.  Agnew  took  a  pathetic  interest  in  this  deserted  little 
spot,  where  so  many  of  his  family  were  laid  to  rest,  and  always, 
when  he  went  to  Gettysburg,  spent  a  portion  of  his  time  in  the 
place,  taking  tracings  of  the  various  stones. 

There  are  few  families  which  exhibit,  to  such  a  marked 
degree,  the  same  physical,  moral,  and  mental  characteristics. 
The  members  of  the  Agnew  family  have  always  been  re- 
markable for  their  great  height  and  splendid  physical  devel- 
opment. It  is,  undoubtedly,  this  great  physical  activity  which 
has  held  them  so  together  as  a  family  through  all  the  tumultu- 
ous and  disturbing  periods  which  succeeded  the  Norman  Con- 
quest in  England,  and  the  same  rude  separating  influences  of 
the  similar  period  of  European  invasion  in  America.  No  finer 
example  exists  of  this  trait  of  height  and  physique  than  in  the 
father  and  uncles  of  Dr.  Agnew.  His  father,  Dr.  Robert 
Agnew,  was  the  shortest  of  seven  brothers,  his  height  being  six 
feet  two  inches.  His  tallest  brother  towered  to  the  height  of 
six  feet  seven  inches.  Another  marked  characteristic  of  the 
Agnew  family  was   their   extraordinary  mental   activity,  and 


LINEAGE   OF   THE    AGNEW   FAMILY.  23 

their  keen  perception  of  the  duties  and  requirements  of  their 
life-work.  No  family  exists  which  shows,  on  a  whole,  a  higher 
degree  of  these  traits.  In  whatever  branch  of  life-work  they  are 
found,  they  stand  pre-eminent. 

Undoubtedly,  however,  the  most  remarkable  characteristic 
possessed  by  the  family  has  been  their  great  prominence  in 
religious  matters.  They  have  been  always  active  in  all  the 
observances  of  religion,  both  in  church-work  and  in  their  daily 
Hfe.  The  three  original  heads  of  the  Agnew  family  in  this 
country  were  all  elders  of  the  same  church, — the  Seceder,  or 
Associate  Presbyterian. 

It  is  a  curious  problem  for  students  of  genealogy  to  note 
that  the  Agneaux  w^ho  remained  in  Normandy,  wholly  separated 
from  their  brethren,  became  Protestants,  as  well  as  did  the 
Scotch  Agnews.  In  fact,  their  Protestantism  w^as  more  remark- 
able because  of  the  adverse  tendency  of  their  surroundings. 

Probably  there  exists  no  fuller  or  more  comprehensive 
biographical  record  of  any  American  family  than  that  of  the 
Agnew  lineage.  Imbued  with  a  clannish  love  of  race,  they 
have  kept  religiously  the  history  of  their  family.  The  various 
American  branches,  like  the  English,  have  been  prolific  of  off- 
spring ;  and  yet,  in  the  various  phases  and  separations  to  which 
American  families  are  subjected,  w^hich  render  any  Hneage  of 
an  American  family  so  difficult  to  complete,  no  traces  of  the 
different  ramifications  have  been  lost.  In  regard  to  the  Ameri- 
can Agnew  family,  much  of  the  credit  for  preserving  these 
records  and  placing  them  together  is  due  to  the  late  Smith 
Agnew,  of  Pittsburgh,  who  devoted  forty  years  of  his  life  in 
traveling  and  collecting,  in  a  permanent  shape,  the  biographical 
outline  of  his  family.  These  records  he  arranged  in  chrono- 
logical order ;  in  this  shape  they  are  invaluable  to  the  American 
Agnew  family. 

James  Agnew,  the  founder  of  this  branch  of  the  family, 
was  born  in  October,  1711,  He  was  married  twice;  by  his 
first  wife  he  had  two  children.     It  is,  however,  with  his  second 


24 


LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 


wife,  Rebecca  Scott,  that  we  are  interested,  for  from  her  Dr. 
Agnew  was  descended.  They  were  married  in  the  year  1737, 
and,  following  out  the  traditions  of  the  Agnew  family,  had 
nine  children,  —  Samuel,  Martha,  James,  David,  Margaret, 
Rebecca,  Sarah,  Abraham,  and  Anne.  Of  these  children,  many 
became  very  well  known  in  the  early  settlement  of  Pennsyl- 
vania. It  is,  however,  the  fourth  child  by  his  second  wife  that 
is  of  importance  to  this  biography. 

The  name  of  this  son  was  David  Agnew,  and  he  was  born 
July  17,  1743.  On  attaining  his  maturity  he  was  married,  in 
Fmnklin  County,  Pennsylvania,  April  2,  1772,  to  Mary  Erwin. 
This  couple  are  of  historic  interest,  for  they  were  the  grand- 
parents of  Dr.  Agnew.  They  had  twelve  children,  which  was 
a  moderate-sized  family  for  an  Agnew.  The  record  of  the  births 
of  these  children  is  so  interesting  that  we  venture  to  copy  this 
portion  of  the  family  record  in  its  entirety.  It  will  be  noticed 
that  a  child  was  born  nearly  every  two  years : — 


Ann,    . 

born  January  9,  IT 73. 

James, 

born  January  18,  1775 

John,  . 

born  April,  14,  1777. 

David, 

born  May  20,  1779. 

Rebecca, 

born  April  5,  1781. 

Mary, 

born  June  29,  1783. 

Robert, 

born  April  21,  1785. 

Samuel, 

born  August  22,  1787. 

Martha, 

born  December  2,  1789 

Smith, 

. 

born  January  14,  1792. 

James  (2d), 

born  January  20,  1794. 

Gibson, 

born  August  3,  1796. 

David  Agnew  did  not  live  to  be  an  old  man,  dying  soon 
after  the  birth  of  his  last  child,  on  the  17th  of  January,  1797,  at 
the  age  of  53  years.  After  four  years  of  widowhood,  Mary 
Agnew,  his  relict,  married  the  Rev.  Alexander  Dobbin,  who  was 
then  a  widower  with  seven  children.  This  made  a  combined 
family  of  eighteen  children.  They  lived  happily  together  until 
her  death,  in  1824. 


LINEAGE    OF    THE    AGNEW    FAMILY.  25 

Robert  Agnew,  the  seventh  child  of  David  and  Mary 
Agnew,  who  was  born  April  21,  1785,  became  later  the  father 
of  David  Hayes  Agnew,  the  subject  of  this  biography.  He 
was  married,  August  1,  1815,  at  30  years  of  age,  by  Rev.  Ebe- 
nezer  Dickey,  to  Agnes  Henderson,  who  was,  at  that  time,  a 
handsome  widow  with  two  cliildren.  Their  only  child  was  bom 
three  years  later,  November,  2-1:,  1818,  and  named  David  Hayes 
Agnew. 

Mrs.  Agnew's  maiden  name  was  Agnes  Noble.  Her  first 
husband  was  the  Rev.  Ebenezer  Henderson,  a  Presbyterian 
minister,  by  whom  she  had  two  children, — James  N.  and 
Mary  A.  Henderson.  The  Rev.  Ebenezer  Henderson  was 
one  of  the  pioneer  Presbyterian  preachers  of  America.  His 
father,  the  Rev.  Matthew  Henderson,  had  been  sent  to  this 
country  by  the  Associate  Synod  of  Edinburgh,  being  the  fourth 
minister  of  that  church,  in  order  of  time,  entering  upon  this 
^vork  in  America.  The  Rev.  Ebenezer  Henderson's  first  charge 
was  in  Pittsburgh,  which  was,  at  that  time,  in  a  very  wild  and 
uncivilized  condition ;  it  being  necessary  to  make  the  trip  over 
the  Allegheny  Mountains  on  horseback.  Mrs.  Henderson,  on 
one  of  these  trips,  carried  her  infant  son  upon  a  pillow  on  the 
saddle  before  her. 

Mrs.  Agnew  frequently  described  the  church  services  of 
those  early  times,  which,  in  the  absence  of  a  church  building, 
were  often  held  in  the  open  air,  even  in  mid-winter  with  the 
ground  covered  with  snow.  A  call  was  given  to  Mr.  Hender- 
son to  succeed  Mr.  Marshall  as  the  pastor  of  the  First  Asso- 
ciate, now  the  First  United  Presbyterian  Church  in  Philadel- 
phia. The  Presbytery  placed  it  in  his  hands  with  the  stipulation 
that  before  entering  on  his  pastoral  work  he  should  visit  the 
scattered  flocks  of  their  adherents  in  the  South.  This  duty  he 
fulfilled,  but  on  his  return  he  was  attacked  by  a  violent  fever 
brought  on  by  exposure  to  the  elements,  swimming  rivers,  etc. 
He  died  at  Staunton,  Va.,  before  he  reached  home.  Intelli- 
gence did  not  then  fly  with  the  speed  of  lightning,  and,  while 


26  LIFE   OF    D.    HATES   AGNEW,    M.D.,    LL.D. 

the  congregation  eagerly  awaited  the  arrival  of  their  pastor-elect, 
they  received  the  news  of  his  death. 

Robert  Agnew,  the  father  of  the  subject  of  this  biography, 
was  born  in  Adams  County,  Pennsylvania.  He  received  his 
general  education  at  Dickinson  College,  and  studied  medicine 
under  that  great  teacher  who  elevated  obstetrics  into  the  dignity 
of  a  distinct  branch  of  medical  study, — Dr.  Thomas  Chalkey 
James,  of  Philadelphia.  After  the  completion  of  his  course  in 
medicine,  he  became  a  surgeon  in  the  U.  S.  Navy.  On  his  first 
trip,  which  was  to  Canton,  China,  the  vessel  in  which  he  sailed, 
left  the  port  of  Philadelphia,  intending  to  round  Cape  Horn 
and  cross  the  Pacific  Ocean.  This  plan,  fortunately  for  posterity, 
was  frustrated  by  an  accident.  The  vessel  was  wrecked,  off  the 
coast  of  North  Carolina,  in  a  storm,  and  Dr.  Agnew,  narrowly 
escaping  death  by  drowning,  reached  shore  in  an  exhausted  con- 
dition. The  vessel  being  totally  destroyed,  there  was  nothing 
left  to  do  but  to  return  to  Philadelphia.  Upon  his  return  Dr. 
Agnew  decided  to  give  up  his  original  intention,  of  becoming  a 
Tiaval  surgeon,  and  remain  on  shore.  Thus,  providentially  jH*e- 
vented  from  leaving  his  native  land,  he  settled  in  Lancaster 
County,  Pennsylvania,  at  Nobleville,  a  town  which  is  now  called 
Christiana.  Here  he  became  extensively  known  and  respected, 
both  as  a  physician  and  a  man.  He  acquired  a  large  practice 
after  a  comparatively  short  residence  in  this  section  of  the 
country,  and  many  of  the  older  genei-ation  still  remember  him 
as  having  been  their  family  physician.  Scores  of  children  in 
Lancaster  and  Chester  Counties  were  named  in  his  honor. 

So  influential  did  his  opinions  become  that  he  was  elected, 
against  his  wishes,  to  represent  Lancaster  County  in  the  State 
Legislature  for  two  successive  terms.  Dr.  Agnew  met  and 
married  his  wife  while  living  at  Nobleville,  and  his  only  son  was 
bom  in  the  quaint  Noble  homestead,  near  Nobleville.  After 
twenty-five  years  of  active  practice  as  a  country  physician,  Dr. 
Robert  Agnew  determined  to  be  relieved  of  his  laborious  duties, 
on  account  of  ill-health  ;  but  he  was  so  popular  and  his  services 


LINEAGE    OF    THE   AGNEW   FAMILY.  27 

were  so  in  demand  that  he  found  the  only  way  to  accomplish 
this  was  to  leave  his  old  home.  Consequently,  he  removed  to 
Baltimore  County,  Maryland,  in  18-iO,  where  he  purchased  a 
handsome  country-seat,  "  Blenheim."  Even  this  change  of 
residence  did  not  prevent  his  being  sought  out  by  his  former 
patients,  or  by  those  who  had  heard  of  his  reputation  as  a  prac- 
tising physician.  In  consequence,  with  the  compliance  which 
was  so  noticeable  in  his  son,  he  visited  the  sick  and  gave  counsel 
for  many  years  afterward,  until  shortly  before  his  death  ;  so  that 
it  can  be  truly  said  that  he  was  engaged  in  the  performance  of 
the  trying  duties  of  a  country  physician  for  nearly  half  a  century. 

The  description  which  exists  of  Dr.  Robert  Agnew's  per- 
sonal appearance  shows  whence  his  son  derived  much  of  his 
physical  and  mental  composition.  He  was  a  very  handsome 
man ;  his  countenance  expressed  the  mildness  and  modesty  of 
his  character,  while  his  height  gave  him  great  dignity  and 
impressiveness.  Yet,  while  modest,  retiring,  and  gentle  in  his 
disposition,  he  possessed  great  determination  of  character ;  and 
when  he  felt  he  was  in  the  right,  he  was  firm  and  inflexible.  He 
was  a  close  observer  of  men  and  things,  and  was  a  keen  student 
on  many  questions.  He  read  and  studied  much,  not  only  in  the 
department  of  medicine,  but  also  in  the  domain  of  general  sci- 
ence and  literature.  He  was  very  methodical  in  all  that  he  did, 
and  showed  great  thoroughness  and  accuracy.  In  fact,  it  is 
stated,  by  all  who  knew  him,  that  he  showed,  in  his  character- 
istics, the  qualities  which  so  distinguished  at  a  later  period  his 
more  celebrated  son. 

Dr.  Robert  Agnew  was  also  prominent  in  the  Presbyterian 
Church,  carrying  out  the  traditions  of  his  family.  In  1828  he 
was  ordained  a  ruling  elder  of  the  congregation  of  the  Presby- 
terian Church  at  Octorara,  and  until  his  removal  to  Maryland 
his  relation  with  Session  was  sympathetic  and  cordial.  He  died 
of  pneumonia,  at  his  residence,  "  Blenheim,"  Baltimore  County, 
Maryland,  October  10,  1858,  at  the  age  of  73  years. 

Mrs.  Agnes  Agnew,  the  mother  of  Dr.  D.  Hayes  Agnew, 


28  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

was  born  in  Lancaster  County,  Pennsylvania,  January  30,  1781, 
this  making  her  four  years  older  than  her  second  husband.  On 
her  side  of  the  house  the  associations  with  the  Presbyterian 
Church  had  been  as  intimate  and  cordial  as  on  the  Agnew  side. 
Her  father,  James  Noble,  had  been  an  elder  in  the  Associate 
Church  at  Octorara,  while  her  grandfather,  William  Noble,  had 
been  one  of  the  founders  of  this  famous  old  church,  which,  with 
the  neighboring  congregation  of  Oxford,  formed  the  original 
seat  of  Associate  Presbyterianism  in  America.  As  has  been  said, 
Mrs.  Agnew  was  wife  first  of  a  minister  and  then  of  a  physician. 
She  was  well  fitted  to  occupy  these  two  prominent  positions  in 
American  society,  for  she  was  a  woman  of  the  most  extraordi- 
nary force  of  character,  possessing  a  powerful  mind  and  an 
indomitable  energy.  From  her  descent  and  her  associations  she 
was  deeply  religious  in  nature,  which  tendency  increased  as  she 
grew  older.  As  a  young  woman,  possessing  a  magnificent 
physique  and  tireless  energy,  she  had  lived  a  life  of  greatest 
hardship  as  the  wife  of  a  frontier  minister.  The  hardships  of 
such  a  life,  which  would  always  fall  harder  on  the  wife  and 
mother  of  the  family,  did  not  aff"ect  her  health  and  spirits  in  the 
least,  although  her  husband,  the  Rev.  Ebenezer  Henderson, 
succumbed  to  them  early  in  his  career. 

As  the  wife  of  the  active  country  practitioner,  Mrs.  Agnew 
brought  into  use  the  energies  and  faculties  which,  by  long  train- 
ing, were  suited  pre-eminently  for  such  work.  Always  serene, 
contented,  and  cheerful,  perfectly  guileless,  and  ingenuous  in 
character,  she  reached  her  old  age  with  a  mind  unusually  clear 
and  full  of  the  knowledge  of  Divine  truth.  Undoubtedly,  to 
her  training  and  influence  her  distinguished  son  owed  many 
of  his  characteristic  traits.  She  walked  daily  with  God,  and 
ripened  for  glory  until  she  reached  her  ninety-first  year,  dying, 
February  25,  1871,  of  a  paralytic  stroke.  Although  she  was 
37  years  of  age  when  her  famous  son  was  born,  she  lived  to  see 
him  reach  a  foremost  position  in  his  professional  work. 

To  the  last  she  was  employed  in  the  reading  of  her  favorite 


LINEAGE    OF    THE    AGNEW    FAMILY.  29 

books.  Her  study  of  the  Bible  occupied  the  principal  portion 
of  her  time,  but  she  was  also  devoted  to  the  standard  religious 
treatises  of  her  youth :  "  Boston's  Fourfold  State,"  "  Owen  on 
Forgiveness  and  on  the  Spirit,"  "  Edwards'  History  of  Re- 
demption," "  Baxter's  Saints'  Rest,"  and  "  Henry's  Commen- 
taries." To  her  son,  when  he  was  summoned  to  her  dying  bed, 
she  said,  "You  have  come  to  see  the  broken  frame  of  your  old 
mother,  but  in  my  feebleness  I  have  still  great  cause  for  thank- 
fulness,— God  has  kept  my  mind  untouched."  And,  as  if  to 
assure  him  of  the  fact,  she  commenced  to  repeat  her  favorite 
chapter,   beginning  "  Let  not  your  heart  be  troubled." 

Her  eldest  son,  James  N.  Henderson,  born  in  1803, 
was,  consequently,  fifteen  years  older  than  his  half-brother. 
He  was  not  married  until  late  in  life,  dying  in  1887,  at  the 
family  seat  near  Baltimore,  aged  84  years.  Mary  A.  Henderson, 
her  only  daughter,  was  born  in  1805.  She  married  Da  vies 
Wallace  and  raised  a  large  family.  She  is  still  living,  her 
home  being  in  Lancaster  County.  Between  this  sister  and  Dr. 
Agnew  there  always  existed  the  greatest  love  and  sympathy. 

A  number  of  Dr.  Agnew's  relatives  became  so  prominent 
in  the  history  of  Pennsylvania  that  they  demand  brief  biog- 
raphies in  any  history  of  the  Agnew  family.  David  Agnew, 
Dr.  Agnew's  grandfather,  was  quite  as  ready  to  resist  oppres- 
sion as  his  ancestors  had  been,  and,  when  hostilities  commenced 
in  the  colonies  against  the  British  rule,  he  espoused  the  colonial 
cause.  Dr.  Agnew's  great-uncle,  James  Agnew,  was  a  colonel 
in  the  Continental  army,  and  was  wounded  in  one  of  the  battles 
in  New  Jersey.  In  that  struggle  many  members  of  the  family 
bore  honorable  and  patriotic  parts,  although  they  knew  that  in 
the  English  army  were  many  relatives  and  friends.  Among 
these  was  General  James  Agnew,  who  fell  at  the  Battle  of 
Germantown,  a  commandmg  officer  in  the  English  army.  The 
followino:  account  of  his  death  at  the  Battle  of  Germantown, 
Philadelphia,  while  a  member  of  the  staff  of  General  Howe,  is 
found  in  Watson's  "  Annals  of  Philadelphia  "  : — 


30  LIFE    OF   D.    HAYES    AGNEW,    M.D.,    LL.D. 

"  At  the  time  of  the  battle,  General  Howe  came  as  far  as 
the  market-square  and  staid  there,  giving  his  commands.  Gen- 
eral Agnew  rode  on  at  the  head  of  his  men,  and  when  he  got 
as  far  as  the  wall  of  the  Mennonite  Church  he  was  shot  by 
Hans  P.  Boyer,  who  lay  in  ambush  and  took  dehberate  aim  at 
the  star  on  his  breast.  He  fell  from  his  horse,  and  was  carried 
to  Mr.  Wistar's  house,  where  he  died  in  the  front  parlor.  Gen- 
eral Agnew  was  a  very  civil  and  gentlemanly  man.  The  man 
who  killed  him  was  not  an  enlisted  soldier.  .  .  .  General 
Agnew  and  Colonel  Bird,  of  the  British  army,  are  both  buried 
in  the  lower  burying-ground,  side  by  side.  General  Agnew 
showed  great  kindness  to  those  with  whom  he  came  in  contact." 

The  house  in  which  General  Agnew  died  was  one  of  the 
celebrated  places  of  the  city  fifty  years  ago.  It  was  photo- 
graphed on  account  of  this  incident,  and  many  of  the  older 
collections  of  the  famous  houses  of  Philadelphia  contain,  a  copy 
of  this  quaint,  old,  typical  Germantown  home,  which  still  stands 
on  Germantown  Poad. 

Dr.  Agnew's  uncle,  Samuel  Agnew,  was  killed,  during  the 
War  of  1812,  at  the  Battle  of  Chippewa.  A  cousin.  Dr.- Samuel 
Agnew,  was  a  surgeon  in  the  army  during  that  period. 

Among  the  best-known  members  of  the  family  was 
Colonel  James  Agnew,  a  cousin  of  Dr.  Agnew,  who  was 
born  in  Adams  County,  Pa.,  July  21,  1769.  His  parents  were 
of  the  Reformed  Presbyterian  (Covenanter)  branch  of  the 
Church ;  but  at  the  time  of  the  union  of  that  body  with  the 
Associate  (Seceders)  Church,  forming  the  Associate  Reform 
Church  of  North  America,  they  joined  in  the  Union.  The 
following  incident,  related  of  his  mother,  Mary  Ramsey,  shows 
the  unsettled  condition  of  the  country:  She  was  attending 
school,  living  for  the  pui-pose  at  the  house  of  a  brother.  Colonel 
Ramsey,  in  Franklin  County.  One  day  she  felt  a  special  aver- 
sion to  going  to  school,  which  became  so  strong  that  she  yielded 
to  it  and  remained  at  home.  That  day  a  band  of  hostile  Indians 
came  upon  the  school-house,  murdering  and  scalping  the  teacher 


LINEAGE    OF    THE    AGNEW    FAMILY.  31 

and  all  the  small  children,  and  carrying  the  larger  boys  and 
girls  into  captivity.  Had  she  gone  to  school  that  day,  she 
would  either  have  been  killed  or  taken  captive. 

At  an  early  age  young  James  Agnew  went  to  live  with  his 
maternal  uncle,  Colonel  Ramsey,  who  owned  an  estate  on  AVest 
Conococheague,  near  Mercersburg.  At  the  time  of  his  advent, 
emigration  to  Western  Pennsylvania  had  been  inaugurated,  and 
a  considerable  trade  was  carried  on  between  the  settlers  west  of 
the  Alleghenies  and  the  older  settlements  of  Cumberland  Val- 
ley. This  trade  was  carried  on  by  means  of  pack-horses,  and 
the  route  corresponded  nearly  with  the  present  turnpike.  By 
the  assistance  of  his  uncle,  young  Agnew  established  a  trading- 
post  in  the  *'  Great  Cove  " ;  the  nearest  store  to  the  east  was 
kept  by  a  Mr.  Buchanan,  whose  son,  James  Buchanan,  after- 
ward became  President  of  the  United  States.  At  this  station, 
where  McConnelsburg  now  stands,  James  Agnew  built  up  a 
very  prosperous  business,  so  that  he  subsequently  became  one 
of  the  wealthiest  men  in  Pennsylvania.  He  was  for  many 
years  a  ruling  elder  in  the  church,  and  his  home  was  known  as 
"  the  ministers'  hotel."  This  arose  from  the  cordial  hospitality 
with  which  clergymen  of  all  denominations  were  received  and 
entertained;  this  hospitality  being  practised  for  weeks  and 
months  at  a  time.  He  was  killed  by  falling  down  stairs,  in 
1855,  in  the  eighty-seventh  year  of  his  age. 

An  incident  which  illustrates  his  character  for  brave  and 
firm  adherence  to  principle  and  law  is  as  follows :  In  those 
days,  before  canals  and  railroads,  the  Conestoga  wagon  was 
the  only  means  of  conveying  freight  from  Philadelpliia  to 
Pittsburgh.  These  sometimes  formed  a  long  caravan  on  the 
road  that  passed  through  McConnelsburg. 

Very  few  teamsters  gave  themselves  and  their  horses  the 
benefit  of  the  Sabbath's  rest ;  the  noise  of  the  wagons  and 
horses,  and  the  boisterous  voices  and  oaths  of  the  drivers, 
became  a  nuisance  to  the  people  along  the  route.  It  was 
known  that  Colonel  Agnew  was  one  of  the  persons  opposed  to 


32  LIFE   OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

this,  and  it  aroused  opposition  among  a  portion  of  the  com- 
munity ;  they  conspired  to  annoy  him  by  nominating  him  for  the 
office  of  constable.  He  was  elected,  and  accepted  at  once  his 
duties.  He  now  determined  to  enforce  the  law,  which  he  did 
with  the  greatest  zeal  and  firmness,  as  it  was  illegal  for  the 
teamsters  to  do  this  transportation  on  Sunday.  One  Monday 
morning,  attempting  to  arrest  a  large  and  powerful  teamster, 
who  had  violated  the  law  the  day  before,  he  was  resisted. 
Colonel  Agnew  was  a  large,  finely-built  man,  over  six  feet  in" 
height,  and  very  strong;  the  teamster  was  also  stalwart  and 
violent,  and  withstood  so  fiercely  that  the  colonel  was  not 
equal  to  the  task.  Dr.  George  Junkin,  who  was  his  guest  at 
the  time,  rushed  to  the  help  of  the  officer ;  by  his  aid  the  giant 
wagoner  was  overpowered  and  carried  before  the  magistrate. 

Colonel  Agnew  was  an  early  and  consistent  friend  of  the 
temperance  reformation.  He  determined  to  banish  all  liquors 
from  his  own  store;  his  partner,  to  whom  one-third  of  the 
profits  was  given,  objected,  as  it  was  a  very  profitable  portion  of 
the  business.  Colonel  Agnew,  however,  directed  his  partner  to 
make  a  calculation  of  the  usual  amount  of  income  from  this 
source.  This  was  done,  and  one-third  of  the  amount  was 
ordered  to  be  added  to  the  partner's  receipts,  and  all  wines  and 
liquors  were  banished  from  the  place. 

Dr.  Samuel  Agnew,  brother  of  James,  was  a  physician,  be- 
ing born,  August  10,  1777,  near  Gettysburg.  After  his  gradua- 
tion at  Dickinson  College,  in  1798,  he  studied  medicine.  Dur- 
ing the  War  of  1812  he  served  as  Surgeon  in  the  Army,  but 
settled  afterward  in  Harrisburg,  Pennsylvania.  He  became  so 
well  known  that  the  late  Professor  Samuel  Jackson,  of  the 
University  of  Pennsylvania,  remarked,  on  one  occasion,  that  "if 
he  had  an  only  son  dangerously  sick,  there  was  no  physician 
between  Philadelphia  and  New  Orleans  whose  services  he  would 
rather  have  than  those  of  Dr.  Samuel  Agnew."  His  eldest 
son  was  the  Rev.  John  Holmes  Agnew ;  his  second  son.  Judge 
James  C.  Agnew.     He  was  a  ruling  elder  in  the  first  Presby- 


LINEAGE    OF   THE    AGNEW   FAMILY.  33 

terian  Church  in  Harrisburg  for  fifteen  years,  and  a  corporate 
member  of  the  American  Board  of  Commissioners  for  Foreiofn 
Missions  for  a  long  time. 

Rev.  John  Holmes  Agnew,  son  of  Dr.  Samuel  Agnew,  and 
cousin  of  Dr.  D.  Hayes  Agnew,  was  born  in  Gettysburg  in  1 804. 
He  became  a  minister,  but  soon  relinquished  pastoral  work  and 
was  elected  Professor  of  Languages  in  Washington  College  in 
1831.  He  subsequently  became  professor  in  a  similar  position  in 
Newark  College,  Delaware,  from  which  he  withdrew  because  the 
funds  for  the  institution  were  raised  by  lottery.  He  was  also  editor 
of  The  Knicherhoclcer,  The  Eclectic  Magazine^  and  the  Biblical 
Repertory^  a  quarterly  in  the  interest  of  the  then  new-school 
branch  of  the  Presbyterian  Church.  He  was  also  author  of  a  valu- 
able work  on  the  Sabbath,  and  he  assisted  in  the  translation  of 
Winer's  "Grammar  of  the  New  Testament."     He  died  in  1865. 

Samuel  Agnew  was  born,  November  18,  1814,  in  McCon- 
nelsburg,  Fulton  County,  Pennsylvania.  He  was  the  youngest 
of  eight  children  of  Colonel  James  Agnew.  He  was  a  student 
for  some  time  at  Washington  College;  subsequently  he  removed 
to  Philadelphia,  where  he  entered  into  business.  After  remain- 
ing several  years  in  business,  he  retired  from  mercantile  pur- 
suits and  engaged  in  the  book-publishing  business  at  Sixth  and 
Chestnut,  bringing  out  the  series  of  Goodrich's  (Peter  Parley's) 
School  Histories.  He  withdrew  from  this  business  about  1855 
and  devoted  his  leisure  time  to  the  formation  of  a  library  for  the 
Presbyterian  Historical  Society,  which  he  originated  in  1852, 
and  of  which  he  was,  until  the  time  of  his  death,  Treasurer  and 
Librarian.  In  addition,  Mr.  Agnew  made  special  collections  of 
books  on  this  subject ;  for  example,  his  collection  of  works  on 
the  subject  of  Baptism  numbered  7000  volumes.  He  was  mar- 
ried, December  10,  1840,  to  Susan,  daughter  of  Robert  and 
Susan  Coxe  Erwin,  and  left  one  child.  Dr.  Erwin  Agnew.  He 
died  in  Philadelphia,  March  6,  1880. 

His  son.  Dr.  Erwin  Agnew,  was  born  February  22,  1842, 
graduating  in  medicine,  at  the  University  of  Pennsylvania,  in 


34:  LIFE    OF   D.    HATES    AGNEW,    M.D.,    LL.D. 

1864.  He  gave  up  the  practice  of  medicine  early  in  his  career, 
and  devoted  himself  to  the  care  of  his  estate.  Although  a  man 
of  most  vigorous  constitution  and  methodical  habits,  and  coming 
of  a  long-lived  race,  yet  his  life  of  great  usefulness  was  cut  short 
by  his  sudden  death,  September  4,  1891. 

The  Hon.  Daniel  Agnew,  ex-Chief  Justice  of  the  Supreme 
Court  of  Pennsylvania,  is  also  a  member  of  the  Agnew  fam- 
ily, his  ancestors  coming  from  the  County  of  Antrim,  in  the 
north  of  Ireland,  in  1764.  Although  no  definite  relationship 
can  be  traced  between  Dr.  Agnew  and  him,  yet  the  resem- 
blance between  his  father  and  uncles  and  Dr.  Agnew's  family 
was  so  striking  that  there  would  be  no  hesitation  on  the  part  of 
a  stranger  to  proclaim  them  near  relatives.  He  was  born,  Janu- 
ary 5,  1809,  in  Trenton,  New  Jersey,  and  was  brought  west, 
in  1813,  to  Beaver,  Pennsylvania,  where  he  resides  at  present. 
Judge  Agnew  has  always  borne  a  prominent  part  in  the  history 
of  Pennsylvania,  and  his  clear  expoundings  of  constitutional  law 
and  legal  points  have  been  received  with  the  greatest  confidence 
and  respect 

His  father,  James  Agnew,  A.M.,  M.D.,  graduated  at  the 
University  of  Pennsylvania,  in  the  Medical  Department,  in 
1800.  His  graduation  thesis  was  on  the  subject  of  "  Perspira- 
tion," and,  as  was  the  custom  at  that  period,  it  was  printed  in 
pamphlet  form,  bound  with  others  in  a  handsome  volume,  and 
presented  to  the  diff'erent  libraries  of  the  time. 

Another  member  of  the  family,  a  cousin  of  Dr.  Agnew, 
was  Dr.  Cornelius  P.  Agnew,  of  New  York,  who  was  born  in 
that  city  in  1830,  and  graduated  at  Columbia  College  in  1848, 
and  afterward  at  the  College  of  Physicians  and  Surgeons.  He 
became  a  distinguished  oculist,  and  died  in  the  midst  of  his 
usefulness,  April  18,  1888. 

Pev.  Benjamin  L.  Agnew,  son  of  Smith  Agnew,  and  a 
cousin  of  Dr.  Agnew,  born  October  2,  1833,  is  a  prominent 
minister  in  the  Presbyterian  Church,  having  at  present  a  charge 
in  Philadelphia. 


LINEAGE  -OF   THE   AGNEW   FAMILY.  35 

The  history  of  the  Agnew  family  is  given  in  its  barest 
outlines,  in  order  to  show  from  whence  the  family  sprung. 
Dr.  Agnew  had  an  honest  appreciation  of  family;  he  did  not 
vahie  a  man  more  or  less  on  account  of  his  ancestry, — not 
for  a  single  moment, — but  he  was  fond,  from  his  earliest  child- 
hood, of  hearing  the  chronicles  of  olden  times,  in  which  his 
family  bore  prominent  parts,  and  of  studying  and  comparing 
the  lives  of  its  different  members.  His  mind  was  stored  with 
the  tales  and  anecdotes  of  years  ago,  and  his  love  for  his  family 
was  one  of  his  most  marked  characteristics. 

An  honest  regard  for  an  honorable  ancestry  is  allowable  in 
the  most  democratic  of  countries. 


CHAPTER  II. 

The  Early  Life  of  Dr.  Agnew. 

Dr.  Agnew  received  his  name  of  David  in  honor  of  his 
grandfather,  David  Agnew.  The  name  of  David  has  always 
been  a  favorite  one  in  the  Agnew  family,  and  his  parents,  in 
giving  him  this  appellation,  simply  followed  out  one  of  the 
customs  of  the  family  in  having  a  David  among  their  children. 
He  received  the  name  of  Hayes  for  his  uncle  by  marriage, — 
Robert  Hayes,  of  Gettysburg;  this  gentleman  had  married 
Rebecca  Agnew,  fifth  child  of  David  and  Mary  Agnew. 

Dr.  Agnew  was  a  "  born  doctor  " ;  he  never  remembered  a 
time  when  he  did  not  desire  to  be  a  physician.  His  father's 
profession  possessed  for  him,  from  his  earliest  childhood,  the 
keenest  and  most  irresistible  fascination.  From  the  time  that 
he  was  first  able  to  play,  he  would  ride  a  cane  for  a  horse,  and, 
clad  in  one  of  his  father's  vests,  which  reached  nearly  to  his 
heels,  he  would  stufi"  his  pockets  with  bottles  and  powders,  and 
pretend  to  visit  his  patients.  At  these  times,  if  any  one  called 
at  the  house  requiring  his  father's  services,  he  would  tell  them 
that  he  had  sent  the  young  doctor  out  to  see  a  patient,  but  that 
the  old  doctor — meaning  himself — was  at  home. 

The  stories  which  are  told  of  the  early  life  of  Dr.  Agnew 
show  that  he  possessed  a  keen  sense  of  humor  and  a  remarka- 
ble intelligence,  even  as  a  very  little  child.  When  scarcely  able 
to  walk  and  talk  he  would  take  his  Grandmother  Noble  by  the 
hand  and  walk  through  the  garden  with  her.  When  he  grew 
weary  he  would  say,  "  Now  let  us  sit  down  and  talk  over  old 
times."  He  loved  to  hear  her  tell  of  Revolutionary  days, — 
the  trials,  anecdotes,  and  incidents  of  that  great  struggle  for 
independence.  He  knew  no  enjoyment  equal  to  this,  and  his 
memory  was  early  stored  with  many  of  the  daring  adventures 
and  thrilling  stories  of  Revolutionary  history. 
(36) 


THE    EARLY    LIFE    OF   DR.    AGNEW.  37 

He  was  never  very  fond  of  going  to  school,  possibly  be- 
cause he  lived  in  what  might  be  called  the  "  Birchen  Age  "  of 
American  education.  This  was  the  time  when  a  teacher  was 
regarded  as  incompetent  unless  he  made  liberal  use  of  the  old- 
fashioned  birch-rod.  Unfortunately,  young  Agnew  had  a  very 
cross  teacher,  who  was  most  proficient  in  the  use  of  this  very 
necessary  instrument  of  education,  and  he  did  not  escape  an 
occasional  punishment  at  the  hands  of  this  pedagogue.  At  one 
time,  after  being  corrected  in  this  manner,  young  David  felt  very 
sick.  His  half-brother,  James  Henderson,  who  was  considerably 
older  than  himself,  happened  to  be  near  the  school,  when  he 
heard  a  sad,  small  voice  cry,  "  Jimmy,  I've  got  the  ague."  The 
little  boy  had  slipped  out  of  school,  and,  seeing  his  brother  in 
the  distance,  had  followed  him.  As  soon  as  "Davy" — as  he 
was  then  called — reached  his  mother,  the  ague  quickly  disap- 
peared, and  David  was  himself  again.  This  little  incident  was 
repeated  a  number  of  times,  until  the  conviction  was  forced 
upon  the  family  that  it  was  a  childish  expedient  to  get  away 
from  his  terrible  teacher. 

When  about  four  years  of  age  his  mother  took  him  to  a 
camp-meeting,  which  was  considered,  in  those  days,  a  necessary 
adjunct  to  religious  training.  Young  David  possessed  a  very 
vivid  imagination,  and,  unfortunately,  one  of  the  preachers  hap- 
pened to  be  telling  the  congregation  about  the  Devil — a  favorite 
subject  at  that  time — just  after  the  arrival  of  his  young  au- 
ditor. Becoming  very  warm  in  his  efforts,  the  minister  pointed 
his  finger  and  cried  out,  dramatically :  "  There  he  is !  Don't 
you  see  him '?"  Young  David  at  this  moment  chanced  to  espy 
a  lizard,  and  called  out  in  return,  at  the  top  of  his  small  voice, 
"  Yes,  I  see  him,  and  I'll  catch  him,  too."  He  caught  the 
lizard,  and  held  it  up  in  triumph.  It  is  needless  to  say  that  his 
mother  took  him  into  custody  as  quickly  as  possible,  but  the 
effect  upon  the  congregation  is  still  remembered  by  those  now 
living  who  were  present. 

When  he  was  three  years  of  age  he  was  being  prepared  for 


38  LIFE    OF   D.    HAYES    AGNEW,    M.D.,    LL.D. 

bed  one  night,  when  suddenly  he  disappeared  and  could  not  be 
found.  After  a  time,  his  sister,  Mary  Henderson,  who  was 
thirteen  years  older  than  he,  was  entertaining  a  gentleman  in 
the  parlor,  when  she  chanced  to  hear  a  small  voice.  This  small 
voice  exclaimed  "  Here  me  is,"  and  out  stepped  young  David, 
proudly,  from  under  the  table  in  the  corner,  clad  only  in  Nature's 
covering,  to  the  great  confusion  of  the  young  people  present. 

There  are  some  children  who,  from  their  earliest  childhood, 
seem  to  realize  fully  the  duties  and  responsibilities  of  life.  Such 
a  child  was  young  David  Agnew;  he  gave  his  attention  from 
the  outset  to  his  religious  duties,  and  his  mother  stated  subse- 
quently that  she  could  never  remember  the  time  when  she  did 
not  feel  that  her  son  was  a  Christian. 

In  those  days  Sabbath-schools  were  few,  and  it  was  the 
universal  custom  for  the  minister  to  catechise  children  publicly 
before  the  church  service.  This  was  an  ordeal  that  helped  to 
make  unhappy  the  existence  of  the  younger  members  of  the 
congregation.  In  these  trials,  however,  young  David  always 
knew  his  lesson  perfectly,  although  frequently  his  study  of  his 
Bible  and  catechism  would  be  put  oif  until  the  very  last  thing 
Saturday  night ;  but  his  memory  was,  from  the  earliest  period, 
most  retentive,  and  it  was  never  any  trouble  for  him  to  learn 
quickly  and  thoroughly. 

His  determination  and  kindness  of  thought  were  exhibited 
from  his  earhest  childhood.  At  one  time  he  was  sick, — so  sick 
that  his  family  thought  he  could  not  live ;  and,  in  consequence, 
his  mother  was  so  much  distressed  by  the  thought  that  she  left 
the  sick-room  for  a  moment.  At  once  he  missed  his  mother, 
and  said  that  they  should  call  her  back  and  tell  her  not  to 
feel  worried  about  him,  for  he  did  not  intend  to  die. 

A  pretty  story  is  told  of  his  first  meeting  with  his  future 
wife.  While  he  was  still  a  small  boy,  a  gentleman  stopped  to 
see  his  father  on  business,  bringing  with  him  a  pretty,  dark- 
haired  little  girl.  The  boy  fell  in  love  with  her  at  once,  and 
made  the  childish   remark   at  the  time,   at  which  every  one 


THE    EARLY    LIFE    OF    DK.    AGNEW.  39 

laughed,  that  he  had  made  up  liis  mind  that  he  would  marry 
her  when  he  grew  up.  Although  he  did  not  meet  the  lady  who 
was  to  be  his  wife  for  many  years  afterward,  to  know  her  well, 
strangely  enough,  the  little  ideal  of  his  boyhood  days  was  the 
one  love  of  his  life — the  woman  to  whom  he  owed  so  much  of 
his  success — the  woman  who  became  to  him,  in  after  years,  a 
real  helpmeet. 

Young  Agnew  was  growing  up  in  the  most  favorable  sur- 
roundings for  his  future  career.  He  was  born  in  a  doctor's 
home ;  he  faced  that  life  from  infancy.  It  was  his  childish 
sport  to  play  the  doctor,  and  lie  grew  naturally  into  the  doctor. 
His  father  and  mother  were  thoughtful  and  honorable  folk,  de- 
voted members  of  the  old  Presbyterian  Church,  lovers  of  their 
Bibles,  students  of  Confession  and  Catechism,  who  gave  many 
proofs  of  the  faith  of  their  ancestors  and  the  strong,  uplifting 
convictions  of  their  own  devout  souls.  Their  boy  was  well 
trained,  and  his  life-record  is  their  monument. 

Through  these  early  years  he  was  perfecting  the  elements 
of  his  vigorous  constitution,  which  stood  him  in  later  years  in 
such  good  stead.  The  boy's  life  in  the  country  then  was  even 
more  out-door  and  wild  than  it  is  now,  for  game  was  then  more 
plentiful  in  the  woods  and  the  country  itself  less  under  the 
control  of  civilization.  In  all  the  boyish  sports  and  games  young 
Agnew  early  took  the  lead  by  his  vigor  and  intelligence.  His 
habits  and  customs  were  being  instilled  into  him  by  his  parents 
and  companions  too  firmly  to  be  changed  to  the  day  of  his 
death  by  the  enervating  influences  of  city  life.  Fortunate  in 
his  parents,  he  was  no  less  fortunate  in  the  location  of  his  early 
home. 

After  his  experience  at  the  country  school,  young  David 
was  sent  to  begin  his  classical  education  at  the  Moscow  Academv, 
which  was  a  flourishing  Chester  County  institution  of  that 
period,  in  charge  of  the  Rev.  Francis  Latta. 

The  incidents  by  which  this  academy  received  its  curious 
name  are  interesting.     At  the  close  of  the  War  of  1812  with 


40  LIFE   OF    D.    HAYES   AGNEW,    M.D.,    LL.D. 

Great  Britain,  there  developed  in  Pennsylvania  a  mania  for  lay- 
ing out  towns.  Among  others  engaged  in  this  project  was  the 
owner  of  a  tavern  called  "  The  General  Wayne,"  on  the  Phila- 
delphia and  Lancaster  Turnpike,  who  sold  his  property,  with 
fifty  acres,  for  the  exorbitant  sum  of  $16,000  to  speculators, 
who  laid  out  thereon  a  town,  to  which  they  gave  the  name  of 
Moscow,  from  the  city  of  Moscow  in  Russia,  which  had  just  been 
consumed  by  fire  started  by  Russian  torches  to  prevent  its  occu- 
pation by  Napoleon  Bonaparte.  These  speculators  disposed  of 
the  property  by  lottery,  the  public-house  being  the  highest 
prize.  The  streets  were  called  by  Russian  names,  and  the  lots 
were  disposed  of  in  this  way  at  high  prices. 

The  town  flourished  only  on  paper,  and  the  project  failed. 
"Cossack  Street"  became  again  the  common  Lancaster  Pike,  and 
the  others,  with  their  Russian  names,  returned  to  the  bosom  of  the 
farm  from  which  they  had  sprung.  It  was  on  this  property  that, 
in  1826,  the  "  Moscow  Academy  "  was  built  by  Mr.  Latta. 

Here  he  received  the  foundations  of  a  good  classical  edu- 
cation, and  from  here  he  was  sent  to  Jefferson  College  at 
Cannonsburgh,  Pa.  This  institution  was  at  that  time  the 
stronghold  of  Presbyterianism  in  the  western  part  of  the  State, 
and  as  such,  naturally,  attracted  the  attention  of  Dr.  Agnew's 
parents,  when  it  became  necessary  to  complete  the  education  of 
their  son.  This  college  was  an  outgrowth  of  the  Cannons- 
burgh Academy  of  tlie  early  part  of  the  present  century.  It 
had  been  named  for  Thomas  Jefferson,  in  the  hope  that  it  would 
receive  aid  from  him  similar  to  that  given  by  Washington  to 
the  college  named  in  his  honor.  Dr.  Agnew  was  a  student 
here  in  the  winter  of  1833-34,  during  the  regime  of  Rev. 
Matthew  Brown,  who  had  been  elected  Principal  in  1822, 
holding  the  position  for  twenty-three  years.  A  further  circum- 
stance which  probably  influenced  his  family  in  the  selection  of 
this  institution  for  the  education  of  their  son  was  the  fact  that 
Rev.  James  Ramsey,  a  connection  of  the  family,  had  been  a 
trustee  of  the  college  from  1805  to  1824. 


THE   EARLY    LIFE    OF    DR.    AGNEW.  41 

Dr.  Agnew  did  not  stay  to  graduate  at  this  institution,  as  he 
had  intended,  but  left  to  enter  Newark  College,  wliich  had  just 
then  been  established  at  Newark,  Delaware,  by  the  Legislature 
of  that  State.  He  was  attracted  to  this  institution  because  his 
cousin,  Rev.  John  Holmes  Agnew,  had  been  elected  Professor  of 
Languages  there.  Newark  College  had  been  established  by  the 
Legislature  of  Delaware  to  afford  higher  educational  facilities 
for  the  residents  of  that  State;  on  May  8,  1834,  it  was  opened 
officially;  the  inauguration  addresses  being  delivered  by  Professors 
Nathan  Munroe  and  John  Holmes  Agnew.  The  college  opened 
with  sixty-three  students  on  the  roll,  but  all  were  so  young  that 
only  one  was  entered  in  the  college  course.  In  1843  the  name 
of  this  institution  was  changed  to  Delaware  College.  It  was 
closed  from  1859  to  1870,  on  account  of  difficulties  in  its  manage- 
ment, but  was  re-opened  and  is  now  in  a  flourishing  condition. 

Dr.  Agnew  was  one  of  the  earliest  students  at  Newark 
College,  entering  in  the  session  of  1834-35.  He  leaves  a 
record  of  his  experience  here,  then  a  boy  of  16,  as  follows: 
"We  were  a  lively  set  of  boys,  and  guilty  of  many  foolish 
pranks,  but,  on  the  whole,  not  worse  than  the  young  men  in 
similar  institutions  at  the  present  time.  The  refectory  was 
infamous, — poor  food,  and  badly  served." 

While  he  was  at  Newark  College,  Dr.  Agnew  was  active 
in  college  life  ;  with  eleven  colleagues  he  founded  the  Atheneum 
Literary  Society,  and  was  one  of  its  most  earnest  supporters. 
Professor  Holmes  Agnew  left  Newark  College  because  it  was 
supported  in  part  by  the  proceeds  of  a  lottery, — a  means  of  sus- 
tenance of  which  he  could  not  approve ;  in  consequence,  there 
was  no  further  inducement  for  his  student-cousin  to  remain. 
Therefore,  Dr.  Agnew  did  not  stay  to  graduate  in  this  institu- 
tion. 

He  had  been  looking  forward  eagerly  for  years  to  the  time 
when  his  father  would  feel  that  he  was  old  enou"h  to  studv 
medicine.  He  now  felt  that  he  had  reached  an  age  when  he 
could  enter  upon  the  study  of  that  profession,  the  performance 


42  LIFE   OF   D.    HAYES    AGNEW,    M.D.,    LL.D. 

of  whose  duties  had  been  the  dream  of  his  boyhood.  There- 
fore, after  studying  for  a  time  at  home,  under  his  father's  direc- 
tions, he  entered  the  Medical  Department  of  the  University  of 
Pennsylvania  in  1836,  being  one  of  the  youngest  members  of 
the  class. 

His  selection  of  the  University  of  Pennsylvania  as  his  school 
for  study  was  a  natural  one.  At  that  time  this  oldest  Ameri- 
can medical  school  stood  easily  at  the  head  of  medical  instruc- 
tion in  America.  Philadelphia  was  then  the  undisputed  centre 
of  medical  instruction,  and  students  were  attracted,  as  they  are 
to-day,  from  all  over  the  Union,  and,  in  many  instances,  from 
far  beyond  the  seas. 

His  advent  at  the  University  of  Pennsylvania  chanced  to 
be  at  a  very  fortunate  period,  for  between  the  years  1834  and 
1840  the  Medical  Department  rose  with  a  bound,  as  it  were, 
from  a  state  of  stagnation  and  torpor  to  one  of  vivid  and  pro- 
ductive activity,  in  which  the  student  who  felt  ambition  stirring 
within  him  was  amply  furnished  with  incentives  to  vigorous 
effort,  with  a  better  provision  for  future  usefulness.  With  the 
reorganization  of  the  Medical  Department,  in  1835,  the  chair  of 
the  Practice  of  Medicine  had  been  separated  from  that  of  the 
Institutes  of  Medicine,  and  Dr.  Samuel  Jackson  was  raised  to 
this  chair;  while  Dr.  Chapman  retained  strictly  the  teaching 
of  Practice.  Dr.  George  B.  Wood  was  elected  to  the  vacant 
chair  of  Materia  Medica  and  Pharmacy.  At  the  same  time, 
ill  health  obliging  the  Professor  of  Obstetrics,  Dr.  Dewees,  to 
resign  the  chair  he  had  so  brilliantly  illustrated,  it  was  filled 
by  Dr.  Hugh  L.  Hodge,  whose  thorough,  systematic,  and  im- 
pressive lectures  inspired  and  guided  his  pupils  for  twenty-eight 
years. 

These  changes  were  most  fortunate ;  they  supplied  fresh 
stimulus  to  the  teaching  force  and  strengthened  the  weak  spots 
in  the  curriculum. 

In  consequence  of  these  alterations,  the  Faculty  at  this 
time  consisted  of  the  following  professors  : — 


THE    EAKLY    LIFE    OF    DR.    AGNEW.  43 

Faculty  of  Medicine  at  the  University  of  Fennsylvania^  1838. 
Nathaniel  Chapman,  M.D.,  Professor  of  the  Practice  of  Physic. 
Robert  Hare,  M.D.,  Professor  of  Chemistry. 
William  Gibson,  M.D.,  Professor  of  Surp:ery. 
William  E.  Horner,  M.D.,  Professor  of  Anatomy. 
Samuel  Jackson,  M.D.,  Professor  of  the  Institutes. 
George  B.  Wood,  M.D.,  Professor  of  Materia  Medica  and  Pharmacy. 
Hugh  L.  Hodge,  M.D.,  Professor  of  Obstetrics  and  the  Diseases  of 

Women  and  Children. 
William  E.  Horner,  M.D.,  Dean  of  the  Faculty. 

From  1835  until  the  year  18i7  no  change  took  place  in 
the  Faculty,  when  Dr.  Hare  resigned  the  Professorship  of 
Chemistry,  having  been  in  possession  of  the  chair  twenty-seven 
years.  As  a  lecturer,  Dr.  Hare  had  been  remarkable  for  the 
skill  of  his  experiments,  which  were  uniformly  successful,  im- 
pressing the  minds  of  the  students  with  their  grandeur.  His 
most  remarkable  discovery  was  the  contrivance  of  the  oxyhy- 
drogen  blow-pipe. 

The  elevation  of  Dr.  Samuel  Jackson  to  the  Professor- 
ship of  the  Institutes  of  Medicine  was  a  fortunate  circumstance 
for  the  University.  Beyond  comparison  the  most  brilliant  and 
speculative  lecturer  in  the  Faculty  of  that  period,  he  had  the 
very  rare  power  of  swaying  his  audiences  with  his  words  and 
tones,  using  this  power  to  take  lofty  views  of  Medicine  as  a 
science  and  an  art. 

Dr.  Nathaniel  Chapman,  as  a  lecturer,  was  self-possessed, 
deliberate,  and  emphatic.  Whenever  warmed  with  his  subject, 
his  animation  became  oratorical.  Often  the  theme  of  dry  matter 
would  be  enlivened  by  some  stroke  of  wit,  happy  pun,  anecdote, 
or  quotation.  He  was  fresh  with  stores  of  facts  and  cases  drawn 
from  his  own  large  experience  and  observation.  His  bearing 
was  dignified,  his  manners  easy,  and  his  gestures  graceful.  He 
had  a  thorough  command  over  the  attention  of  his  class,  with 
whom  he  always  possessed  unbounded  popularity.  His  voice 
had  a  peculiar  intonation,  depending  upon  some  defect  in  the 
conformation  of  the  palate,  which  rendered  the  articulation  of 


44  LIFE    OF   D.    HAYES    AGNEW,    M.D.,    LL.D. 

some  words  an  effort.  When  one  became  accustomed,  how- 
ever, to  the  tone,  his  enunciation  was  remarkable  for  its 
distinctness.^ 

Dr.  William  Gibson,  as  a  teacher,  was  clear  and  emphatic; 
his  voice  was  distinct  and  melodious,  his  language  was  well- 
chosen,  and  his  style  of  enunciation  was  attractive.  His  demon- 
strations of  surgical  anatomy  were  readily  comprehended  by 
the  student ;  some  of  them  could  not  be  surpassed  in  any  respect. 
For  the  purposes  of  demonstration.  Dr.  Gibson  had  prepared 
himself,  and  procured  by  purchase,  an  ample  collection  of  morbid 
structures,  of  diseased  and  fractured  bones,  models  and  casts,  as 
well  as  pictures  of  large  size,  illustrative  of  diseases,  or  of  the 
anatomical  parts  of  the  body  involved  in  operations.  To  these 
were  added  the  approved  mechanical  appliances  of  that  day.  In 
teaching  in  this  manner,  he  set  the  example  that  has  been  fol- 
lowed extensively  by  other  surgeons  ever  since.  As  an  operator 
he  was  undoubtedly  dexterous. 

Professor  Horner  was  not  fluent  or  copious  in  language, 
nor  had  he  any  pretensions  to  elocution.  His  plan  of  teaching, 
to  a  certain  extent,  was  novel.  He  composed  a  text-book  which 
was  a  complete  but  concise  treatise  on  anatomy.  It  was  written 
in  strict  reference  to  the  course  of  study  in  the  University  of 
Pennsylvania,  and  was  kept  in  as  concise  a  style  as  possible,  so 
that  there  should  be  no  unnecessary  loss  of  time  in  reading  it. 
In  the  lecture-room  he  confined  himself  chiefly  to  the  demonstra- 
tions of  the  text  of  his  work  by  discussions,  preparations,  draw- 
ings, and  models.  As  to  the  value  of  this  method  there  may  be 
different  opinions,  but  it  made  good  anatomists.  The  students 
of  the  time  frequently  declared  that,  plain,  simple,  and  un- 
adorned   as   were   the   lectures   of  Dr.  Horner,   they   learned 

1  Dr.  Chapman's  readiness  in  repartee  may  be  illustrated  by  the  following-,  in  con- 
nection with  the  election  of  a  colleague.  When  Dr.  Dorsey  was  chosen  to  succeed  Dr.  Wis- 
tar,  he  was  much  gratified  and  elated  at  the  prospect  presented  him  of  distinction  in  the 
chair  of  Anatomy.  Expressing  himself  enthusiastically  with  reference  to  his  hope  of 
acquiring  reputation  in  that  branch,  Dr.  Chapman  remarked  that  this  had  been  already 
accomplished,  as  a  muscle  had  been  named  after  him,— the  latissimus  dorsi. 


THE    EARLY    LIFE    OF    DR.    AGXETT.  45 

anatomy  better  from  him  than  from  any  other  teacher.  The 
Anatomical  ^Museum  of  the  University,  which  had  been  founded 
by  Dr.  Wistar,  was  greatly  enlarged  by  the  anatomical  skill  and 
untiring  application  of  Dr.  Horner, 

Professor  Wood's  connection  with  the  University  forms  one 
of  its  brightest  glories.  His  election  to  the  chair  of  Materia 
Medica  and  Pharmacy  had  been  productive  of  new  interest  in 
that  branch  in  consequence  of  its  being  made  more  demonstrative. 

This  constituted  the  faculty  which  gave  Dr.  Agnew  his 
first  medical  instruction.  He  was  always  particularly  fond  of 
describing  their  traits  and  characteristics,  and  the  last  speech 
he  ever  made,  less  than  a  month  before  his  death,  was  devoted 
to  this  congenial  theme.  Dr.  Agnew  behoved  firmly  what 
another  student  of  the  period  has  pleasantly  said:  "It  is  my 
pleasure  to  imagine  that  they  have  not  been  excelled  to  the 
present  day."  This  is  the  universal,  loyal  consensus  of  belief 
of  all  the  students  of  the  thirties. 

In  order  to  see  the  extent  of  medical  instruction  of  that 
day,  with  its  advantages  and  limitations,  a  short  resume  of  the 
curriculum  is  necessary.  The  instruction  in  the  medical  schools 
at  this  period  can  be  seen  from  the  roster,  which  included  the 
fundamental  branches  of  Medical  Science,  Materia  Medica  and 
Pharmacy,  Surgery,  Practice  of  Medicine,  Chemistry,  Anatomy, 
Midwifery,  and  Institutes  of  Medicine.  The  very  insignificant 
proportion  of  practical  work  formerly  required  of  the  student, 
and  the  preponderance  of  it  at  the  present  time,  is  the  most 
noticeable  change  in  medical  instruction. 

It  is  the  spirit  of  the  age  to  deride  the  past  and  underrate 
its  advantages.  There  is  no  doubt  but  that  there  is  too  low  an 
estimate  placed  on  the  extent  and  thoroughness  of  the  medical 
teaching  in  the  thirties.  The  minuter  points  of  medical  science 
are  forgotten  by  the  physician  soon  after  his  graduation,  and 
only  the  practical  knowledge  which  he  needs  remains.  This 
does  not  vary  so  much  from  the  knowledge  of  fifty  years  ago 
as  w^ould  appear  at  first  sight. 


46  LIFE   OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

Fifty  years  ago  personal  practical  work  was  not  required 
of  the  students  ;  they  derived  nearly  all  they  learned  from  didactic 
lectures  and  "  clinical  conferences,"  so  called.  Only  a  few  en- 
joyed the  good  fortune  of  receiving  the  personal  bedside  teach- 
ing of  gentlemen  who  had  themselves  been  trained  in  the 
Paris  hospitals.  Through  these  younger  men  a  wider  knowl- 
edge of  practical  medicine  and  surgery  became  disseminated. 
A  similar  revolution  gradually  took  place  in  other  cities,  until, 
at  the  present  day,  the  American  graduate  in  medicine  enters 
upon  his  professional  life  with  a  far  completer  panoply  than 
was  dreamed  of  by  the  reformers  of  half  a  century  ago. 

Still,  the  young  men  of  the  period  were  as  studious  as  those 
of  any  other  decade,  and  many  of  them  were  anxious  to  pursue 
a  longer  course  than  was  demanded  by  the  medical  schools, — 
attendance  on  two  courses  of  lectures  being  all  that  was  required. 
In  the  course  of  1832-33  there  were  forty-seven  students  who 
were  in  attendance  beyond  the  second  course  and  twenty-six 
who  held  the  degree  of  M.D.  In  1833-34  there  were  forty- 
three  of  the  former  class  and  thirty-one  of  the  latter  class.  In 
1834-35  there  were  forty-seven  on  a  longer  course  and  twenty- 
six  doctors  of  medicine.  After  this  time  the  catalogues  did  not 
report  such  students.  It  is  known  that  many  of  those  who 
were  the  most  successful  in  their  professional  life  attended  three 
courses  of  lectures  by  their  own  choice. 

It  was  not  in  didactic  lectures  only  that  improvement  took 
place.  From  the  commencement  of  medical  teaching  in  Phil- 
adelphia bedside  instruction  had  indeed  been  given  at  the 
Pennsylvania  Hospital  and  at  the  Almshouse,  but  the  credit  of 
introducing  medical  patients  before  students  in  a  lecture-room  is 
ascribed  to  Dr.  Benjamin  H.  Coates,^  physician  to  the  Pennsyl- 
vania Hospital,  in  1834,  although  these  cliniques  were  but  little 
less  than  informal  didactic  expositions  of  the  diseases  which  the 
patients  who  were  exhibited  happened  to  present.     It  was  not 

1  Dr.  Traill  Green  states  that,  when  he  was  a  student  at  the  University,  in  1834,. 
cliniques  at  the  Pennsylvania  Hospital  had  been  held  for  some  time  prior  to  this  date. 


TUE    EARLY    LIFE    OF    DR.    AGNEW.  47 

until  the  return  of  Drs.  Gerhard  and  Pennock  from  Europe,  and 
the  election  of  the  former  to  the  Pennsylvania  Hospital  as 
attending  physician,  and  of  both  gentlemen  as  attending  phy- 
sicians to  the  Philadelphia  Hospital,  that  clinical  medicine 
bes^an  to  be  tau^lit  in  a  systematic  and  fruitful  manner. 

With  surgical  cliniques  the  case  was  somewhat  different, 
since  they  conveyed,  for  the  most  part,  instruction  through  the 
eye  rather  than  through  the  understanding,  and,  therefore,  they 
have  always  attracted  students  by  their  spectacular  qualities. 
During  the  period  1833  to  1840,  the  two  great  hospitals  were 
served  by  surgeons  who  were  most  eminent.  At  the  Alms- 
house Hospital,  the  staff  included  Drs.  AVilliam  Gibson,  Joseph 
Pancoast,  William  E.  Horner,  and  Richard  Harlan ;  at  the 
Pennsylvania  Hospital,  Drs.  Thomas  T.  Hewson,  Jolm  Rhea 
Barton,  Thomas  Harris,  Jacob  Randolph,  and  George  W. 
N  orris. 

It  would  be  difficult  to  find,  anywhere,  a  corps  of  surgeons 
more  skillful,  judicious,  and  successful  than  these.  Horner  was 
distinguished  by  his  precision,  Gibson  by  his  clearness,  Pancoast 
by  his  vast  experience.  Hewson  by  his  learning,  Harris  by  his 
prudence  and  knowledge  of  principles,  Xorris  by  his  wise  con- 
servatism and  clinical  investigations,  and  Barton  by  his  ambi- 
dextrous skill,  which  he,  as  it  were,  bequeathed  to  one  of  his 
successors, — Agnew. 

In  these  surgical  operations,  before  the  introduction  of 
anesthesia,  pain  was  not  in  all  cases  a  depressing  influence ;  for 
example,  a  boy  was  cut  for  stone,  in  the  Pennsylvania  Hospital, 
by  lateral  section ;  he  promised  that  he  would  lie  perfectly  still 
if  he  were  allowed  to  smoke  a  cigar  during  the  operation.  He 
bore  the  cutting  with  impassive  tranquility. 

The  infusion  of  new  life  and  vigor  into  the  Medical  Faculty 
of  the  University  of  Pennsylvania  was  not  followed  by  an 
immediate  and  permanent  increase  in  the  size  of  the  classes. 
Probably,  in  the  present  instance,  the  critics  were  too  far  away 
and  too  ill-informed  to  learn  of  the  improvement  in  the  medical 


48  LIFE    OF    D.    HAYES   AGNEW,    M.D.,    LL.D. 

instruction  here.  The  greater  number  of  students  were  drawn 
from  the  Southern  States;  in  1833-34,  out  of  a  total  number 
of  four  hundred  and  thirty-two,  no  less  than  two  hundred  and 
thirty  came  from  States  south  and  west  of  Delaware.  Yet, 
under  the  new  regime  begun  in  1835,  there  was  a  steady 
increase  in  numbers  until  the  Civil  War,  in  1861-62. 

At  about  this  date,  1836,  student  life  became  more  sedate, 
owing  probably  to  the  changes  made  in  the  Faculty,  which 
tended  to  inspire  the  young  men  with  more  serious  ideas  of  the 
nature  and  purpose  of  their  studies.  This  reformation  occurred 
almost  simultaneously  with  a  similar  improvement,  which  took 
place  in  London,  and  which  had  been  attributed  in  that  instance 
to  the  genial  but  biting  satire  of  the  "  Medical  Student,"  in  Punch. 

During  the  period  1830  to  1840  the  medical  department 
occupied  what  was  then  its  new  hall  on  Ninth  Street  above 
Chestnut.  A  large  proportion  of  the  first-course  students  wore 
a  decidedly  bucolic  aspect  in  manners  and  apparel.  Very  many 
of  the  classes  of  those  days  came  from  the  Old  Dominion ;  they 
brought  with  them,  along  with  the  wealth  they  lavishly  dis- 
pensed, a  freedom,  not  to  say  a  license  of  bearing,  which 
caused  not  only  themselves,  but  the  whole  medical  class  they 
were  supposed  to  typify,  to  be  called  "'Ginny  Students"  by 
the  vulgar.  They  were  specially  looked  at  askance  by  the 
colored  people,  among  whom  a  superstition  prevailed  that  these 
gay  young  doctors  "  burked  "  negroes  for  the  anatomical  rooms. 

In  those  days  it  was  no  uncommon  occurrence  for  medical 
students  to  engage  in  brawls  in  theatres  and  other  public  places, 
and  to  pass  more  or  less  of  the  night  in  the  lock-up,  unless 
liberated  by  the  intervention  of  some  professor.  Indeed,  going 
bail  for  disorderly  students  was  regarded  as  an  incident  of  the 
professorial  functions.  This  custom  was  a  natural  result  of  the 
closer  personal  relations  existing  between  the  professors  and 
students  than  have  prevailed  of  later  years.  Almost  every  pro- 
fessor had  a  large  class  of  private  and  office  students,  being 
so  large  in  some  instances  as  to  become  cumbrous.     This  fact 


THE    EARLY    LIFE    OF    DR.    AGNEW.  49 

led,  on  the  one  hand,  to  the  estabhsliment  of  the  Medical  Insti- 
tute by  Professor  Chapman,  in  which  he  associated  with  him- 
self several  of  his  colleagues  in  the  Faculty,  together  with  one 
or  two  physicians  who  were  not  connected  with  the  University, 
and,  on  the  other  hand,  to  tlie  organization  of  several  more  or 
less  private  quiz  classes.  The  first  of  these  was  established  by 
the  late  Dr.  Thomas  Dent  Mutter,  afterward  Professor  of  Sur- 
gery in  the  Jefferson  Medical  College,  and  by  Dr.  Paul  Beck 
Goddard,  so  distinguished  as  an  anatomist.  The  classes  for 
private  instruction  were  numerous. 

A  great  feature  of  medical  instruction  at  this  time  was  the 
summer  courses  of  lectures  with  private  instruction.  In  some 
instances,  it  was  absolutely  necessary  for  tlie  students  to  take 
some  of  these  courses ;  for  example.  Dr.  Chapman's  lectures  on 
Practice  at  the  University  was  not  completed  there,  and  his 
lectures  in  the  Medical  Institute  filled  out  the  course.  His 
lectures  on  the  diseases  of  the  nervous  system  he  delivered 
during  the  summer  months. 

It  was  the  practice  of  the  students  of  this  period  to  form 
quiz  clubs,  consisting  of  six  or  seven  members,  each  member  rep- 
resenting a  professor.  The  duty  of  the  member  was  to  listen 
diligently  to  the  instruction  of  the  lecturer  or  professor  he  rep- 
resented and  record  notes.  The  club  met  in  the  evening,  and 
each  member  in  turn  quizzed  the  others.  Every  week  or  every 
two  weeks,  the  members  changed  the  subjects ;  for  example, 
the  man  who  had  quizzed  on  chemistry  exchanged  witli  the  man 
who  had  quizzed  on  materia  medica ;  so  that  each  member  of 
the  club,  in  turn,  quizzed  on  all  the  branches  during  the  lecture 
course.  These  quiz  clubs  were  possibly  more  effectual  than 
the  modern  method  of  employing  quiz  masters,  for  each  member 
had  a  motive  in  taking  notes  on  his  subject,  in  the  hope  that  he 
might  have  the  pleasure  of  "  stumping  "  some  of  his  colleagues 
at  the  club  meetings.  In  this  way  a  spirit  of  rivalry  and  compe- 
tition was  begotten,  which  spurred  the  students  on  to  acquire 
fuller  and  more  accurate  medical  knowledge. 


50  LIFE   OF   D.    HAYES    AGNEW,    M.D.,    LL.D. 

It  was  the  custom  of  two  of  the  professors  to  entertain  the 
graduatmg  class  at  theu'  houses  on  Commencement  eve,  when 
the  provision  was  less  ascetic  than  is  usual  in  these  abstemious 
days.  The  consequences  were  not  always  edifying  from  a  decor- 
ous point  of  view ;  but  the  soberest  among  them  may,  perhaps, 
be  pardoned  for  indulging  a  little  in  the  greatest  saturnalia  of 
their  lives.  They  had,  but  a  short  time  before,  passed  through 
the  ordeal  of  the  "  Green  Box,"  which  was  once  a  literal  closet 
where  the  candidate  for  the  degree  was  given  over  to  his  tor- 
mentors. 

The  "  Green  Box,"  or  "  Green  Eoom,"  which  is  still  even 
employed  as  the  term  for  an  examination  in  medical  subjects, 
arose  from  the  practice  of  the  professors  at  one  period — 1810 
to  1821 — examining  the  candidates  for  the  degree  of  medicine 
behind  a  screen.  This  was  a  modification  of  the  method  which 
had  been  in  operation  before  1810,  when  the  professors  ex- 
amined first  the  student  privately,  and  then  publicly  before  the 
trustees  to  exhibit  his  fitness  for  the  honor  of  the  doctorate. 

The  number  graduating  with  Dr.  Agnew  at  the  Medical  Com- 
mencement, April  6,  1838,  was  144;  at  the  Commencement  of 
the  college  department  on  July  12th  12  more  were  added  to  this 
list,  making  a  total  of  156.  In  the  "  General  Catalogue  of  the 
Medical  Department  of  the  University  of  Pennsylvania,  with  an 
Historical  Sketch  of  the  Medical  Department,  published  by  the 
Direction  of  the  Medical  Faculty  of  the  University  of  Penn- 
sylvania, third  edition,  1845,"  the  number  of  matriculates  is 
given  as  380  and  the  graduates  as  157.  This  slight  mistake 
in  the  number  of  graduates  is  due  to  the  duplication  of  the 
name  of  one  of  the  students. 

The  Commencement  was  held  at  Musical  Fund  Hall,  on 
Locust  Street,  between  Eighth  and  Ninth  Streets.  It  occurred 
during  a  period  of  a  few  years,  in  which  the  University  term 
was  prolonged  to  six  months,  being  afterward  reduced  again  to 
a  period  of  five  months.  Among  his  class-mates  and  fellow- 
graduates  were  John  Forsyth  Meigs;  Joseph  K.  Barnes,  late 


THE    EARLY    LIFE    OF    DR.    AGNEW.  51 

Surgeon-General  U.  S.  Army  ;  Philip  Lansdale,  Surgeon  U.  S. 
Navy ;  James  L.  Tyson,  now  living  at  Pcnllyn,  Montgomery 
County,  Pennsylvania,  formerly  Professor  of  Materia  Medica  in 
the  Philadelphia  Medical  College;  Azariah  B.  Newell,  at  one 
time  Governor  of  New  Jersey  ;  John  D.  Griscom,  formerly  a 
well-known  practitioner  in  Philadelphia,  who  was  subsequently 
a  neighbor  of  Dr.  Agnew  at  Haverford ;  Henry  E.  Muhlenburg, 
of  Reading;  and  Joseph  Hopkinson,  Jr.,  who  was  in  charge 
of  the  Mower  Hospital  during  the  Civil  War. 

A  search  through  the  "  National  Directory  of  Physicians  for 
the  United  States  "  discloses  the  fact  that  in  1890  there  were  at 
least  twelve  members  of  the  class  of  1838  still  living.  Subse- 
quent inquiries,  made  during  the  summer  of  1892,  revealed  the 
fact  that,  out  of  this  number,  probably  only  four  members  re- 
mained, the  other  eight  dying  in  the  last  two  years.  The  living 
members  (1892)  as  far  as  are  known  are  Drs.  James  L.  Tyson, 
Penllyn,  Pennsylvania;  S.  G.  Fauntleroy,  Dragonsville,  Virginia; 
James  L.  Motley,  Sharp's  Wharf,  Virginia ;  and  Philip  Lans- 
dale, retired  Medical  Director  in  the  U.  S.  Navy,  Philadelphia. 

The  following  description  of  Dr.  Agnew  at  this  period  is 
given  by  a  former  class-mate  : — 

"I  knew  D.  Hayes  Agnew  in  1838,  when  I  graduated  at 
the  University  of  Pennsylvania,  but  my  relations  with  him  were 
not  intimate.  He  was  a  quiet  gentleman,  as  I  remember  him, 
but  indefatigable  in  his  close  attendance  in  the  lecture-room.  It 
was  the  custom  of  some  of  the  professors,  in  that  day,  to  cate- 
chise the  two  first  rows  of  students  on  the  subjects  of  the  pre- 
ceding lectures, — particularly  by  Horner  on  Anatomy,  Wood 
on  Materia  Medica,  and  Hodge  on  Obstetrics,  as  well  as  occa- 
sionally Gibson  on  Surgery, — so  that  the  questions  and  answers 
could  be  heard  throughout  the  rotunda.  Being  one  of  these, 
and  familiar  with  most  of  the  others  who  underwent  this 
somewhat  trying  ordeal,  I  remember  that  Agnew's  well-marked 
presence  was  seldom  absent  at  these  times,  especially  if  anatomy 
or  surgery  were  the  themes.     More  than  half  a  century  has 


52  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

elapsed  since  the  time  referred  to ;  but  I  find  that  my  memory, 
although  occasionally  a  little  treacherous,  is  more  tenacious  of 
distant  events  than  of  those  of  more  recent  origin. 

"The  subject  of  slavery  in  the  South  was  at  that  period  rife 
in  the  minds  of  all,  and  many  collisions,  engendered  by  discus- 
sions on  the  prolific  theme,  gave  rise  to  divers  canings  and  fisti- 
cuff's among  the  malcontents;  so  much  so  that  Professor  Gibson 
one  day  made  the  remark  that  'the  very  devil  seemed  to  have 
broken  out  among  the  students.'  In  none  of  these  dissensions, 
however,  did  Mr.  Agnew  in  any  way  participate,  but  quietly 
pursued  his  studies,  undeterred  by  the  conflicting  elements 
around  him. 

"  Not  far  from  the  University,  which  was,  at  the  time  I 
refer  to,  on  Ninth  Street,  north  of  Chestnut,  there  was,  in  a 
back  street,  near  by,  a  certain  house  whose  rooms  were  appro- 
priated for  anatomical  dissections  by  some  specialists  in  that 
department,  which  I  had  desired  to  possess,  with  a  view  of  pur- 
suing and  perfecting  my  studies  in  that  branch ;  but  to  my 
chagrin,  at  the  time,  I  learned  they  had  already  come  into  the 
possession  of  Mr.  Agnew,  and  I  have  little  doubt  that  here  he 
laid  the  first  foundation  of  his  great  skill  in  surgical  operations, 
which  was  destined  to  place  his-  name  high  on  the  rolls  of  fame 
in  Surgery,  unsurpassed  as  he  was  in  this  or  any  country  in  the 
world." 

As  shown  in  this  account,  there  was  a  custom  among  the 
students  at  this  period  of  engaging  such  rooms  for  anatomical 
work.  They  were  not  connected  in  any  way  with  the  School  of 
Anatomy,  which  was  then  in  active  operation,  under  the  care 
of  Dr.  Joseph  Pancoast,  although  on  the  same  street. 

Agnew's  determination  to  study  anatomy  more  fully  even 
than  was  required  by  the  curriculum  throws  an  interesting  light 
on  his  ambition.  His  love  for  this  laborious  and  too  frequently 
neglected  branch  of  medicine  was  not  acquired ;  it  was  instinct- 
ive. As  he  expressed  it  himself,  in  speaking  of  the  dissecting- 
room  of  the  School  of  Anatomy :  "  Those  dingy  old  rooms  had 


TUE    EARLY    LIFE    OF    DR.    AGNEW.  53 

more  attractions  for  me  than  the  frescoed  and  fretted  walls  of  a 
palace,  and  tliose  anatomical  odors  were  sweeter  far  than  those 
of  Araby  the  blest." 

Dr.  Agnew  registered  himself  for  graduation  as  David 
H.  Agnew,  the  title  of  his  graduating  thesis  being  "Medical 
Science,  and  the  Responsibility  of  Medical  Character."  Up  to 
this  time,  and  until  after  his  marriage,  he  signed  himself  in  this 
manner,  making  the  change  to  D.  Hayes  Agnew  at  the  solicita- 
tion of  his  wife,  who  disliked  greatly  the  name  of  David. 

During  the  fire  in  the  Medical  Department  at  the  Univer- 
sity, May  30,  1888,  the  Stille  Library,  a  valuable  collection  of 
medical  books,  in  the  third  story  of  the  Medical  Hall,  was  dam- 
aged by  water  to  such  an  extent  that,  at  the  recent  re-arrange- 
ment of  the  books  in  the  University  Library,  those  that  had 
been  rendered  illegible  Avere  destroyed.  Unfortunately,  all  the 
theses  for  the  year  1838  were  among  this  number  to  be  de- 
stroyed ;  consequently,  all  trace  is  gone  forever  of  Dr.  Agnew's 
graduating  essay.  Curiously  enough,  the  essays  for  the  years 
prior  to  1838  are  in  a  good  state  of  preservation,  as  are  also 
those  after  the  year  1839,  the  years  missing  being  1838  and 
1839.  Fate  seems  to  have  decreed  that  one  of  the  few  essays 
which  would  be  of  interest  at  present  should  be  lost. 

It  is  to  be  doubted,  however,  whether  the  entire  loss  of 
these  graduating  theses  would  be  a  serious  blow  to  medical 
literature.  They  were  composed  under  unfortunate  circum- 
stances, at  a  time  when  the  medical  students  were  worn  out  and 
depressed  by  a  hard  winter's  course  ;  their  composition  was  re- 
garded as  an  irksome  and  unpleasant  task ;  but  little  time  could 
be  given  for  original  investigation,  consequently  they  were  copied 
largely  from  the  text-books,  and  they  were  shirked  as  much  as 
possible.  In  consequence,  many  of  them  are  decidedly  school- 
boyish  in  composition  and  in  the  treatment  of  their  subjects.  On 
the  other  hand,  the  necessity  for  reading  one  hundred  and  fifty 
of  these  essays  annually  was  an  equally  unpleasant  task  for  the 
Faculty.     The  removal  of  this  requisite  for  graduation  within 


54  LIFE    OF    D.    HAYES   AGNEW,    M.D.,    LL.D. 

the  past  fifteen  years  was  a  wise  act  on  the  part  of  the  authorities 
of  the  Medical  Department. 

Although  Dr.  Agnew's  graduating  thesis  has  been  de- 
stroyed, yet  it  is  possible  to  see  its  drift  from  its  title;  he  always 
held  strict  ideas  upon  the  special  responsibilities  of  a  physician, 
and,  undoubtedly,  in  this  first  essay,  wrote  on  a  subject  which 
was  an  especial  favorite  with  him  during  his  whole  life. 

After  graduating  at  the  University  of  Pennsylvania,  in  1838, 
Dr.  Agnew  returned  to  Nobleville  in  order  to  assist  his  father 
in  his  very  extensive  practice.  He  remained  with  his  father  in 
this  capacity  for  two  years,  until  the  latter's  removal  to  Mary- 
land, in  1840.  The  elder  Agnew  was  a  terrible  sufferer  from 
asthma,  and  his  removal  was  made  not  merely  to  get  rid  of  the 
exactions  of  a  laborious  country  practice,  but  also  in  the  hope 
of  finding  a  climate  more  suited  to  his  constitution.  After  his 
removal  to  Maryland,  he  suffered  but  little  from  his  asthmatic 
attacks.  The  younger  Agnew  lived,  at  this  time,  in  the  old  Noble 
homestead,  where  his  parents  had  lived  before  him  for  many 
years. 

His  mother's  family  had  long  dwelt  in  tliis  location.  The 
village  had  been  called  for  a  long  time  Nobleville,  in  honor  of 
the  family.  It  was  south  of  the  Philadelphia  and  Columbia 
Railroad,  subsequently  the  Pennsylvania  Railroad,  which  had 
just  been  built  to  connect  Philadelphia  with  the  canals  fartlier 
west.  Its  title  was  changed  to  Christiana,  in  1847,  in  honor  of 
Christiana  Noble,  wife  of  William  Noble,  Dr.  Agnew's  uncle. 

While  living  here  he  formed  the  acquaintance  of  the 
lady  who  was  to  play,  subsequently,  an  important  part  in  his 
career,  Margaret  Creighton  Irwin,  daughter  of  Samuel  Irwin, 
of  Pleasant  Garden  Iron- Works.  Their  parents  had  been 
friends  for  a  long  time.  Dr.  Robert  Agnew  having  been  their 
family  physician  for  many  years.  On  his  removal  south,  in 
1840,  the  younger  Dr.  Agnew  was  called  in  to  attend  some 
members  of  the  Irwin  family  who  had  been  injured  in  an  acci- 
dent.    The  relations  between  Dr.  Agnew  and  the  Irwin  family 


THE    EARLY    LIFE    OF    DR.    AGNEW.  55 

continued  to  grow  more  intimate,  until,  finally,  the  strong  at- 
tacliment  between  Miss  Irwin  and  himself  culminated  in  their 
marriage  at  the  old  homestead,  at  Pleasant  Garden,  Chester 
County,  Pennsylvania,  the  wedding  ceremony  being  performed 
•by  Rev.  Wm.  Easton,  on  November  21,  1841,  three  days  before 
the  doctor's  twenty-third  birthday. 

Mrs.  Agnew's  family  were  so  solicitous  for  the  young  couple 
to  live  at  home  with  them  that  they  spent  the  winter  of  1841—42 
at  Pleasant  Garden,  Dr.  Agnew  continuing  his  practice  at  this 
point.  In  the  spring,  however,  they  determined  to  return  to 
his  original  office,  in  the  old  homestead  at  Xobleville.  They 
remained  here  until  Dr.  Agnew  decided  to  give  up  practice,  a 
year  later. 

Samuel  Irwin,  Mrs.  Agnew's  father,  died  March  17,  1842, 
leaving  his  large  business  to  his  children. 

The  selection  of  his  future  companion  and  helpmate  was  one 
of  the  most  fortunate  circumstances  of  his  life.  It  is  hard  to 
say  how  much  of  Dr.  Agnew's  success  was  due  to  his  wife,  but 
certainly  a  large  portion  of  it  was  the  result  of  her  energy,  in- 
telligence, and  determination ;  for  she  supplied  the  tireless,  ever- 
active  impetus  which  kept  him  from  being  satisfied  with  his  first 
efforts.  He  learned  at  this  time  a  young  doctor's  life  of  incessant 
and  ill-paid  toil  in  that  finest  of  first  fields  for  medical  activity, 
— a  diversified  country  practice, — where  a  man  of  medicine  is 
sailed  for  all  time  from  cramping  one-sidedness,  and  where,  of 
necessity,  he  endures  hardness  and  makes  firm  backbone.  They 
were  days  of  wearing  toil,  of  sturdy  effort,  and  steady  struggle. 
He  has  told,  in  his  own  calm,  crisp,  cheery  sentences,  of  those 
first  years  of  professional  life, — "hard  riding,  hard  reading,  hard 
working,  and  small  fees."  Here  it  was  he  gained  first  his  own 
resistless  eye  of  instantaneous  insight  from  which  nothing 
seemed  to  be  hidden,  that  marvelous  judgment  for  the  subtle 
secrets  of  the  human  body,  those  nimble  fingers  apt  for  any 
delicate  operation,  and  those  unrivaled  hands  of  co-equal  power. 

Dr.  Agnew  was,  at  that  time,  a  famous  sportsman;  he  loved 


56  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

to  take  his  gun  and  go  in  search  of  game,  which  was  then  very 
plentiful  in  the  woods  of  Lancaster  and  Chester  Counties.  In 
such  expeditions  he  became  a  leader  from  his  earliest  youth, 
and  his  fame  as  a  hunter  still  lingers  as  a  legend  in  these 
regions.  There  were  one  or  two  incidents  of  this  wild  out- 
door life  that  he  could  never  forget,  especially  as,  in  one  of 
these  occurrences,  he  nearly  lost  his  life.  In  Lancaster  County, 
in  those  years,  fox-hunts  were  a  great  source  of  amusement  and 
recreation.  Dr.  Agnew  took  the  foremost  place  in  these  hunts, 
riding  a  famous  jumper  called  "  Tom."  This  was  not  so  much 
an  individual  as  a  generic  equine  appellation,  for  the  steed  was 
of  a  breed  called  "  Toms,"  found  only  in  Baltimore  County, 
Maryland.  History  says,  no  doubt  with  truth,  that  a  British 
officer,  during  the  Kevolutionary  war,  left  a  magnificent  stalHon 
in  Baltimore  County,  which  was  the  sire  of  the  "  Tom"  breed 
of  horses,  famous  for  more  than  a  century  in  Maryland.  They 
are  closely  built,  muscular,  great  jumpers,  with  wonderful  en- 
durance, intelHgence,  and  spirits.  Most  of  them  are  of  a  bay 
color,  with  black  manes  and  tails,  and  arched  necks.  All  these 
peculiarities,  in  a  remarkable  degree,  were  possessed  by  Dr. 
Agnew's  fox-hunter, — an  animal  that  was  long  famous,  even  in 
Lancaster  County,  for  its  speed  and  abilities  as  a  jumper. 

It  was  a  frosty  morning  in  the  fall  when  Dr.  Agnew  and 
several  other  gentlemen  followed  a  pack  of  fox-hounds  to  the 
fields  in  a  particularly  beautiful  portion  of  fair  old  "  Lancaster  "  ; 
the  dogs  soon  striking  the  trail  of  the  fox,  dashed  off  in  full  cry. 
After  them  rode  the  hunters,  with  rapidly  increasing  speed,  over 
corn-fields  and  across  ditches,  jumping  such  fences  as  came  in 
their  way,  filled  with  the  delight  of  the  ride  in  the  crisp  air 
and  the  excitement  of  the  chase.  The  fox  led  toward  a  range 
of  hills,  and,  while  the  others  kept  on  directly  after  the  hounds. 
Dr.  Agnew  took  a  "  short  cut "  across  country,  intending  to 
head  off  reynard  as  he  turned  back  on  his  tracks,  as  he  was 
almost  sure  to  do. 

"  Tom  "  bore  his  master  gallantly  across  a  decidedly  rough 


THE    EARLY    LIFE    OF    DR.    AGNEW.  57 

country,  leaping  ditches  as  if  the  task  were  sport  and  sailing 
over  low  fences  and  hedges  as  birds  sail  over  a  line  of  trees.  The 
cries  of  the  liounds  grew  fainter  in  the  distance  as  thev  kept 
straight  on  upon  the  trail  of  the  fox,  and  the  other  hunters  had 
long  passed  out  of  sight;  but,  knowing  well  "the  lay  of  the 
land,"  Dr.  Agnew  pressed  on  until  he  saw  an  exceedinglv  higli 
fence  before  him,  and  pulled  on  the  bridle  to  clieck  "  Tom  " 
until  lie  could  lower  the  rails  for  a  passage.  The  horse's  blood 
was  up  ;  lie,  too,  felt  all  the  excitement  of  the  chase,  and,  taking 
the  bit  in  his  teeth,  he  rushed  on.  His  rider,  seeing  how  near 
the  fence  was,  whipped  the  steed  and  let  him  go  as  he  would. 
The  horse,  when  a  few  feet  from  the  fence,  made  a  long  jump, 
rising  in  the  air  like  a  lark  from  her  nest ;  but  his  hoofs  stnick 
the  top  rail  and  down  he  fell  on  the  opposite  side,  throwing  his 
rider  off  with  a  stirrup  entangled  about  one  foot. 

Dr.  Agnew  was  thrown  partially  in  front  of  the  horse,  and 
he  knew  that  if  the  animal  stirred  he  would  be  dragged.  He 
knew,  too,  in  a  moment,  that  "  Tom  "  might  roll  forward — 
the  animal  was  on  its  knees — and  crush  him  to  death ;  but  the 
blooded  animal  did  not  stir.  Although  the  horse  was  on  his 
knees,  with  his  hind  legs  half  crushed  under  him,  he  lay  like  a 
block  of  stone,  looking  at  his  master.  Slowly,  painfully,  the 
bruised  physician  disentangled  the  stirrup,  and,  rising  to  his 
feet,  found  that  no  bones  were  broken.  Xot  until  then  did 
"  Tom  "  rise.  The  physician  gratefully  reflected,  as  he  rode 
slowly  homeward,  pretty  well  shaken  up,  upon  the  intelligence 
displayed  by  the  horse,  which  saved  his  master  from  injury, 
probably  from  death. 

Some  years  later  Dr.  Agnew  became  fond  of  duck-shooting. 
For  a  number  of  years  he  went  regularly  to  Chesapeake  Bay 
to  indulge  in  this  fascinating  sport.  About  eighteen  miles 
below  Havre-de-Grace  there  is  an  island  famous  among  duck- 
shooters,  where  Dr.  Agnew  had  many  remarkable  experiences, 
so  far  as  exciting  sport  was  concerned.  On  one  occasion  the 
doctor's  boatman  told  him,  as  the  sun  began  to  decline,  that  he 


58  LIFE    OF    D.    HAYES   AGNEW,    M.D.,    LL.D. 

would  have  a  wonderful  experience,  if  he  did  not  mind  standing 
in  water  up  to  his  knees  for  about  half  an  hour. 

Twenty  minutes  later,  just  as  the  sun  dipped  beyond  the 
western  horizon,  and  it  was  "  neither  day  nor  night,"  Dr.  Agnew 
and  his  boatman,  standing  in  water  near  the  edge  of  the  bay, 
and  concealed  in  the  tussocks,  held  their  guns  in  readiness. 
Pretty  soon  a  cloud  appeared, — a  cloud  of  black  ducks  coming 
to  roost.  As  they  passed  overhead,  the  guns  re-echoed  and 
scores  of  the  water-fowl  fell  dead.  The  sportsmen  hardly  had 
time  to  reload  before  another  flock  came.  Many  more  were 
bagged.  Then  the  ducks  were  seen  on  all  sides.  They  came 
in  flocks  of  hundreds  each,  to  roost  in  the  tussocks  as  the  twi- 
light deepened,  and  in  the  aggregate  they  numbered  thousands. 
The  hunters  killed  ducks  by  the  score  until  it  became  dark, 
which  was  about  twenty  minutes  after  the  arrival  of  the  first 
bunch  of  water-fowl.  There  are  not  now  many  such  duck-roosts 
in  the  world. 

Dr.  Agnew  was  never  a  happier  or  more  attractive  com- 
panion than  when  off  for  a  day  with  dog  and  gun.  During  his 
connection  with  the  School  of  Anatomy  this  formed  his  only 
recreation,  and  in  after  years  he  often  spoke  of  these  happy 
days  with  the  greatest  pleasure.  At  that  time  he  was  a 
superb  shot  and  a  stranger  to  fatigue.  His  steadiness  of  hand, 
quick,  decisive  judgment,  and  sharp  eye  were  as  useful  to 
him  as  the  successful  sportsman  as  they  were  in  the  successful 
surgeon. 

As  Dr.  Agrnew  grew  older,  he  gave  up  entirely  all  his 
expeditions  as  a  sportsman,  although  he  still  retained  a  love  and 
appreciation  for  the  pleasure  of  the  chase ;  but  his  time  was  too 
fully  occupied  for  him  to  indulge  in  this  favorite  pastime  of  his 
earlier  manhood. 

Dr.  Agnew  was  one  of  the  best  judges  of  horse-flesh  that  it 
is  possible  to  become.  All  his  life  he  had  a  fondness  and  admi- 
ration for  that  noble  animal,  and  he  could  take  in  at  a  glance  all 
its  good  qualities  and  defects.     If  he  approved  of  the  selection 


THE    EARLY    LIFE    OF    DR.    AGNEW.  59 

of  an  animal,  its  purchaser  could  rest  satisfied  that  it  was  all 
that  had  been  claimed  for  it. 

Dr.  Ai>ne\v  had  now  been  in  practice  for  nearly  five  years, 
during-  which  time  he  had  been  busily  engaged  in  work.  He 
was  happily  married,  and  had  apparently  settled  down  to  his 
life-work  as  a  country  physician;  but  just  at  this  time,  through 
the  instrumentality  of  his  marriage,  he  gave  up  his  profession  for 
a  time,  and  unconsciously  mapped  out  for  himself  a  totally  differ- 
ent career,  even,  from  the  new  work  which  he  had  undertaken. 
As  he  said  himself,  in  his  speech  at  his  own  jubilee  banquet: 
"Any  man  who  has  lived  long  in  this  world,  and  has  taken  a 
thoughtful  retrospect  of  his  life,  must  be  forced  to  confess  that 
the  influences  and  forces  which  have  conspired  to  mold  his 
character  and  to  shape  his  destiny  are  most  mysterious  indeed. 
Plans  constructed  with  infinite  care  have  miscarried ;  fondly- 
cherished  hopes  have  suddenly  been  crushed  with  a  shock; 
glowing  anticipations  just  about  to  become  realizations  are  dissi- 
pated in  a  moment  into  thin,  viewless  air,  like  earth-mists  before 
the  morning  sun." 

The  details  of  this  change  in  the  life  of  Dr.  Agnew,  which 
gave  him  eventually  a  career  undreamed  of  at  this  time,  are 
given  in  the  next  chapter. 


CHAPTER  III. 

The.  Story  of  Dr.  Agnew's  Business  Venture. 

The  story  has  been  told  that  Dr.  Agnew,  discouraged  by 
his  prospects  in  medicine  and  feehng  himself  unfitted  for  its 
practice,  determined  to  give  up  his  professional  life  and  go 
into  business.  This  incident  has  often  been  cited  as  an  illus- 
tration to  encourage  the  medical  graduate  of  to-day  who 
sees  in  the  future  no  opening  for  himself;  its  application  is 
obvious.  This  story  is  partly  true,  and  partly  false.  Dr. 
Agnew  did  not  give  up  the  practice  of  medicine  because  he 
felt  that  he  was  unfitted  for  it,  or  because  he  felt  that  there 
was  no  future  in  it  for  him,  but  because  he  thought  he  saw  a 
much  greater  opening  in  another  direction.  There  came  an 
opportunity  to  him  of  immediate  advancement,  in  his  early 
professional  life,  which  he  did  not  dare  ignore,  although  it  is 
true  that  his  consent  to  it  was  most  reluctantly  given ;  for  his 
love  for  medical  work,  as  he  has  said  himself,  was  inborn, 
wrought  into  the  very  fibre  of  his  mental  organization. 

His  father-in-law,  Samuel  Irwin,  was  a  well-known  and 
prosperous  iron-founder  of  the  early  part  of  the  century.  He 
had  furnaces  on  Bush  Hiver,  near  Baltimore ;  at  Pleasant  Gar- 
den and  at  Washington  Forges,  near  Bellefonte,  in  this  State. 
The  firm  in  Baltimore  was  Irwin  &  Patterson, — the  Patterson 
being  the  brother-in-law  of  Jerome  Bonaparte ;  the  firm  name 
in  Pleasant  Garden  was  simply  Samuel  Irwin ;  in  Bellefonte  it 
was  Irwin  &  Houston.  He  had,  in  addition,  a  number  of  large 
stores,  to  supply  the  necessaries  of  life  to  his  workmen  at  tliese 
different  points.  As  he  grew  older,  the  care  of  these  industries 
devolved  more  and  more  upon  his  sons,  until  at  his  death  they 
assumed  control  of  his  large  business.  Then  it  was  that  Dr. 
Agnew  was  invited  to  enter  the  firm,  to  represent  the  interests 
of  his  wife. 
(60) 


DR.    AGNEW'S    BUSINESS    VENTURE.  61 

His  progress  in  practice  in  the  country  had  been  fairly 
successful.  He  had  been  cordially  received  by  the  people,  on 
account  of  the  pleasant  memories  which  had  been  left  by  liis 
father,  who  had  been  a  practising  physician  in  this  locality  for 
many  years ;  but,  of  course,  practice  in  the  country,  as  well  as 
elsewhere,  is,  at  the  outset,  not  particularly  lucrative  to  a  young 
man.  It  requires  years  to  establish  the  confidence  and  to  acquire 
that  acquaintanceship  which  lays  the  foundation  of  a  physician's 
success.  His  principal  competitor  was  Dr.  Xathaniel  Sample, 
who  at  that  time  had  reached  an  honorable  old  age,  having 
earned  a  reputation  which  made  him  the  leading  practitioner 
of  the  region, — skillful,  capable,  and  honest. 

Consequently,  this  admission  into  the  partnership  of  a  large 
manufacturing  concern  was  a  flattering  opportunity  to  the  young 
country  practitioner;  although,  knowing  his  own  nature  so 
thoroughly,  his  consent  was  given  reluctantly.  Therefore,  in 
184:3  Dr.  Agnew  relinquished  all  idea  of  continuing  his  medical 
work,  and  joined  his  brothers-in-law  in  the  management  of  the 
iron-works  at  Pleasant  Garden,  Chester  County,  Pennsylvania. 

At  this  time  that  great  revolution  in  business  methods — 
the  logical  sequence  of  the  introduction  of  new  agencies  in  the 
mercantile  world — was  just  beginning.  The  electric  telegraph, 
the  railroad,  the  extended  use  of  steam  as  a  power,  and  the  in- 
vention of  improved  machinery  were  all  making  new  conditions 
in  the  industrial  world.  Xcw  competitors  were  springing  up  every- 
where in  every  business ;  competition  was  becoming  closer  and 
keener ;  those  industries  which  were  disadvantageously  placed 
in  any  way,  in  the  new  order  of  things,  were  being  pushed  slowly 
but  inevitably  to  the  wall. 

It  was  the  mill-race  aoainst  the  steam-eniiine,  the  Conestoo:a 
wagon  against  the  freight-car.  Xo  such  revolution  had  been 
known  before  in  the  business  world ;  consequently,  its  forces 
and  powers  were  not  quickly  grasped  or  utilized  by  all  the  busi- 
ness men  of  the  period.  Because  their  flithers  or  grandfathers 
had  made  money  in  the  old  way,  many  clung  to  their  old  loca- 


62  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

tions,  old  machinery,  old  methods  of  business,  old  means  of 
transportation.  It  was  this  spirit  which  drove  the  great  whal- 
ing firms  of  New  Bedford,  bringing  their  oil  from  far-distant, 
perilous,  and  uncertain  sources,  to  attempt  to  compete  with  the 
great  oil-wells  of  Pennsylvania,  spouting  their  thousands  of 
gallons  daily.  The  result  was  typical  of  the  conflict  everywhere. 
The  great  fortunes  of  the  whalers  ^  melted  away  like  mist  before 
the  summer  sun,  in  the  fierce  but  unequal  competition  with  the 
penniless  but  clear-headed  men  who  saw  the  real  outlook  of  the 
future,  and  who  were  straining  every  nerve  to  get  money  to  buy 
oil-lands.  This  struggle  went  on  in  every  business ;  the  simple 
rules  of  political  economy  were  being  fought  against  in  vain. 

The  wrecks  of  this  terrific  storm  still  strew  the  country, 
forming  its  only  ruins.  How  often,  in  a  drive  through  the  shaded 
roads,  alongside  many  of  the  tumultuous  streams  of  central 
New  York  or  Pennsylvania,  can  be  found  the  romantically- 
deserted  mill  or  moss-covered  factory  which  once  echoed  to  the 
ceaseless  hum  of  industry !  These  romantic  spots,  now  so  sug- 
gestive of  legend  or  story,  were  made  by  the  practical  demands 
of  commonplace,  commonsense  business.  It  is  stern  reality, 
curiously  enough,  that  makes  the  romance  of  this  world. 

Among  other  industries,  there  occurred  no  greater  revolu- 
tion than  in  the  iron  business.  Formerly,  the  iron  was  found  in 
small  quantities  in  isolated  spots  and  hauled  by  wagon  many 
miles  to  the  foundry  or  the  rolling-mill,  where  it  was  smelted  by 
specially  prepared  charcoal  or  by  coal  brought  from  a  distance. 
The  manner  in  which  the  work  was  done,  as  compared  with 
the  tremendous  modern  methods,  was  mere  child's  play.  Often 
great  works  were  built  which  depended  on  the  iron  found  in 
the  peat  of  swamps  along  the  coast-line.  "  The  ruined  village 
of  Allaire,"  near  Spring  Lake  Beach,  New  Jersey,  with  its  rows 
of  empty  houses  opening  on  grass-grown  streets,  and  its  gaunt, 
huge  foundry  buildings,  with  their  gaping  windows,  forming  as 

1  In  justice,  it  must  be  stated  that  some  of  the  whaling  firms  saw  the  temporary 
nature  of  their  business  long  before  its  destruction. 


DR.    AGNEW'S   BUSINESS   VENTURE.  63 

true  a  deserted  village  as  ever  was  painted  by  Goldsmith,  is  a 
typical  example  of  this  kind. 

In  order  to  see  the  position  of  the  Pleasant  Garden  Iron- 
Works  in  the  business  world  of  the  period,  and  the  various 
agencies  which  were  at  work,  it  is  necessary  to  present  a  brief 
outline  of  the  history  of  iron-making,  and  the  various  sudden 
revolutions  which  have  occurred  in  its  history.  As  far  as  can 
be  determined,  the  first  iron-works  in  Pennsylvania  were  estab- 
lished in  1718,  by  Thomas  K-utter,  near  the  present  city  of 
Pottstown. 

Of  course,  the  works  of  the  eighteenth  century  were  of 
the  most  primitive  character ;  such  a  works,  in  those  days,  being 
called  a  "  bloomary,"  or  Pool  forge.  The  forge,  at  that  time, 
occupied  a  far  more  prominent  position  than  it  does  at  present, 
being  the  great  means  by  which  pig-iron  was  converted  into 
marketable  articles.  This  work,  which  is  now  done  by  the  roll- 
ing-mill, was  hammered  out  by  hand  on  the  forge,  the  product 
being  called  "  bloom,"  deriving  its  name  from  the  fact  that  when 
hammered  into  shape  on  the  anvil,  it  was  the  flower  of  the 
metal,  gaining  its  name  from  the  German  term  "  blume,"  a 
flower.  This  product  was  made  from  cast-  or  pig-  iron,  or 
even  directly  from  the  ore.  Until  1838,  all  iron-furnaces  in  the 
United  States,  with  the  exception  of  a  few  coke-furnaces,  used 
charcoal  as  fuel.  All  furnaces,  at  this  time,  were  blown  by 
water-power,  and  the  blast  was  always  cold. 

In  1838  anthracite  or  stone  coal  first  came  into  use  as  fuel 
for  iron-works.  Its  introduction  into  the  manufacture  of  iron 
gave  a  great  impetus  to  the  industry  everywhere,  and  it  was 
followed  by  the  establishment  of  many  other  furnaces  in  other 
parts  of  the  country.  Raw  bituminous  coal  w^as  used  as  fuel 
for  the  same  purpose  in  1843.  The  first  Lake  Superior  iron-ore 
used  in  a  blast-furnace,  curiously  enough,  was  brought  by  David 
and  John  P.  Agnew  to  their  furnaces  at  Sharpsville,  Pennsyl- 
vania, in  1853. 

At  this  time,  outside  communication  and  the  means  of  trans- 


64  LIFE    OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

porta  tioii  being  limited  and  equally  good  to  all,  and  the  demand 
coming  from  no  great  distance,  the  importance  of  being  accessi- 
ble to  the  market  was  not  appreciated.  In  those  days  there 
were  no  railroads  or  canals  in  existence,  and  every  one  was 
obliged  to  cart  his  merchandise  by  wagon.  In  consequence, 
these  forges  were  placed  in  locations  which,  nowadays,  seem  out 
of  the  way. 

One  of  the  favorite  situations  at  this  time,  for  an  iron- 
works, was  in  the  range  of  hills  running  down  from  the  AUe- 
ghenies  to  the  sea,  extending  through  the  pleasant,  fertile  farm- 
lands of  Chester  County,  on  the  border  of  Mason's  and  Dixon's 
Line.  These  ranges  of  high  hills  afforded  two  great  advan- 
tages :  in  the  first  place,  charcoal,  which  was  then  the  great 
means  for  smelting  iron,  was  one  of  the  most  expensive  factors 
in  the  iron  industry;  consequently,  the  location  of  the  iron- 
works in  the  midst  of  a  densely  wooded  region  afforded  access 
to  a  large  and  practically  inexhaustible  supply  of  fuel.  In  the 
second  place,  the  waters  of  the  rapid  streams  which  were  found 
among  these  hills  afforded  the  great  source  of  power.  The 
arrangement  of  the  land  by  nature  was  such  that  dams  could 
be  built  and  fine  water-supplies  obtained  at  a  very  moderate 
outlay  of  money. 

As  time  wore  by,  the  disadvantages  of  such  a  location  as 
that  chosen  by  Samuel  Irwin  for  the  site  of  his  iron-works,  on 
the  Big  Elk  Creek,  became  more  apparent.  The  Reading  Rail- 
road was  finished  in  1838;  the  great  Pennsylvania  Canal,  with 
its  Portage  and  Columbia  Auxiliary  Railroad,  was  opened  for 
traffic  in  1834;  and  by  1840  communication  had  been  opened 
with  the  Great  Lakes  at  Cleveland,  by  means  of  the  Beaver 
River  and  the  Ohio  Canal.  In  1840  the  State  of  Pennsylvania 
had  974  miles  of  canals  and  953  miles  of  railroads;  thus,  it 
can  be  seen  that  the  means  of  transportation  were  being  rapidly 
extended. 

Forges,  at  this  time,  were  beginning  to  stop  the  manu- 
facture of  bar-iron,  leaving  its  production  to  the  rolling-mills, 


DR.    AGNEW'S   BUSINESS   VENTURE.  65 

forced  by  the  many  improvements  in  the  various  processes  which 
were  made  continually  in  the  manufacture  of  iron ;  in  1836 
furnace  gases  were  first  utilized  for  increasing  the  heat  of  the 
fuel;  in  1838  the  hot  blast  came  into  use. 

The  business  life  of  the  iron-manufacturer,  at  this  period, 
was  particularly  hard  and  precarious.  His  business  was  open  to 
such  disadvantages  and  losses  that  it  early  dawned  upon  the 
government  that  protection  must  be  given  to  this  branch  of  in- 
dustry; in  consequence,  in  1836,  corporations  for  the  mining 
and  working  of  iron  were  favored  by  legislative  act.  This  was 
necessary  on  account  of  the  panic  which  was  approaching,  and 
because  of  the  strong  alien  influence  at  work,  exerted  by  the 
English  iron-workers,  who  were  at  that  time  in  a  more  pros- 
perous position  than  their  American  competitors.  It  has  been 
stated,  on  good  authority,  that  scarcely  an  American  firm  engaged 
in  the  iron  industry  made  money  between  the  years  1840  and 
1850,  and  countless  numbers  of  firms  were  forced  to  succumb. 

The  iron  industry  of  Pennsylvania  has  always  been  one  of 
the  most  important  and  typical  features  of  this  commonwealth. 
The  iron-workers  of  Pennsylvania  were  most  influential  in  the 
settlement  of  the  State.  Except  for  tlie  thinning  out  of  the 
forests  to  obtain  the  charcoal  for  their  furnaces,  there  would  not 
have  been  a  sufiicient  number  of  acres  cleared  to  have  allowed 
the  farmer  to  do  his  work  satisfactorily,  for  the  farmer  did  not 
have  sufficient  inducement  to  do  tliis  work  for  himself  In  con- 
sequence, agriculture  would  have  lagged.  The  forgemen  and 
furnacemen,  in  the  history  of  Pennsylvania,  were  never  far 
behind  the  pioneer  with  his  rifle.  If  it  were  not  for  the  exist- 
ence of  forges,  furnaces,  and  rolling-mills,  also,  there  would  not 
have  been  so  much  inducement  for  the  improvement  of  the 
means  of  transportation.  History  shows  that  canals  were  first 
used  for  this  branch  of  industry.  Again,  the  necessity  for  a 
larger  quantity  and  a  better  quality  of  fuel  led  the  way  to  the 
introduction  and  utilization  of  anthracite  coal.  The  history  of 
the  coal  industry  goes  hand  in  hand  with  that  of  iron. 


66  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

The  panic  of  1837,  which  was  followed  by  a  period  of 
intense  financial  depression  throughout  the  country,  was  felt  most 
severely  in  the  iron  industries.  It  handicapped  the  iron-workers, 
who  were  already  at  a  disadvantage  in  competition  with  Great 
Britain.  The  amount  of  pig-iron  produced  fell,  in  one  year, 
to  233,000  tons,  from  390,000  tons  of  the  year  before.  It  was 
only  by  the  imposition  of  a  high  protective  tariff",  by  the  organiza- 
tion of  corporations,  with  large  amounts  of  capital  to  draw  upon, 
and  by  many  favors  of  legislative  action,  that  the  iron  business 
was  nursed  until  it  grew  to  its  present  colossal  proportions. 

The  Pleasant  Garden  Iron-Works  was  a  most  perfect  ex- 
ample of  the  old-fashioned  method  of  producing  iron.  In  1811 
Ellis  Passmore  built  a  forge  on  the  Big  Elk  Creek,  five  miles 
southeast  of  Oxford,  and  two  and  one-half  miles  southwest  of 
New  London,  in  Chester  County.  He  also  erected,  in  this 
beautiful  valley,  a  handsome  colonial  residence,  two  and  one- 
half  stories  high,  built  of  stone,  and  a  typical  example  of  this 
pretty  style  of  architecture.  Shortly  after  this  time  he  sold  the 
works  to  his  brother-in-law,  Samuel  Irwin.  Mr.  Irwin  con- 
ducted these  works  most  successfully,  and  at  his  death,  in  1842, 
the  business  had  grown  until  there  was  a  large  collection  of 
buildings  here,  in  which  the  work  was  carried  on,  or  in  which 
the  workmen  lived. 

When  Dr.  Agnew  was  admitted  to  the  firm,  some  of  these 
disadvantages  were  already  felt.  Pealizing  that  they  must 
keep  up  with  the  advances  and  improvements  in  the  iron  in- 
dustry, they  added  a  rolling-mill,  at  the  expense  of  many 
thousand  dollars,  in  1845.  Their  location  had  been  excellently 
selected.  It  is  conceded  to-day  to  be  one  of  the  best  water-rights 
in  the  State.  The  dam  supplied  a  water-power  dependent  on  a 
lake  extending  backward  for  a  mile  and  a  half;  but  by  this 
time  the  works  were  far  from  railroad,  river,  and  canal ;  its  ore 
had  to  be  hauled  from  a  distance ;  its  fuel  was  old-fashioned  and 
second-rate ;  its  power  uncertain  and  weak,  compared  to  the 
newer  sources  of  power. 


DR.    AGNEW'S   BUSINESS   VENTURE.  67 

The  transformation  occurred  almost  in  the  twinkhng  of  an. 
eye,  from  tlie  time  when  the  old-fashioned  iron-works  in  the 
densely  grown  woods  on  the  babbling-  streams  of  Pennsylvania 
made  its  owners'  fortunes,  to  the  period  when  an  iron-works 
required,  for  its  successful  continuance,  three  vital  factors, — 
the  cheapest  fuel,  the  most  extensive  connections  by  rail  and 
canal,  and  the  best  ore.  The  change  took  place  with  such 
lightning  rapidity  that  it  startles  even  the  observer  of  to-day 
studying  its  phenomena. 

It  was  just  at  this  time  that  Dr.  Agnew  was  admitted  to 
partnership,  and  the  firm  name  became  Irwin  &  Agnew.  Had 
he  gone  into  the  industry  ten  years  before  he  would  have  been 
successful  in  it,  and  America  would  have  lost  her  greatest 
surgeon.     How  mscrutable  are  the  ways  of  Providence ! 

The  iron  used  at  Pleasant  Garden  was  not  mined  here,  but 
was  hauled  by  eight-horse  teams  from  Port  Deposit,  Elkton, 
Perryville,  and  other  points  at  a  considerable  distance,  necessi- 
tating, of  course,  a  considerable  expense  in  the  manufacture  of 
its  products.  The  iron-foundry  was  in  a  most  unfavorable 
natural  position  to  compete  with  the  newer  mines  in  better  loca- 
tions being  worked  everywhere.  These  influences  had  not  been 
felt  in  the  original  growth  of  the  concern. 

To  the  credit  of  Dr.  Agnew's  business  sagacity  it  must  be 
said  that  the  circumstances  of  the  business  made  it  such  that 
it  had  to  struggle  at  this  point,  without  the  possibility  of  seek- 
ing a  newer  and  more  favorable  location.  Many  diff'erent 
interests  were  involved,  and  no  concerted  action  to  remove  was 
feasible. 

The  firm  of  Irwin  &  Agnew  made  a  long  and  determined 
struggle  against  unequal  forces.  In  this  they  were  somewhat 
handicapped  by  the  fact  that  the  resources  of  the  firm  had 
been  lost  to  a  considerable  extent  in  various  ways.  After  the 
maintenance  of  the  firm  for  three  years  after  the  admission  of 
Dr.  Agnew,  they  were  eventually  obliged  to  succumb,  and  con- 
sequently  to   assign.      During    this   time   Dr.    Agnew  worked 


68  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

with  the  greatest  zeal  and  intelHgence  to  maintain  the  sinking 
fortunes  of  the  estate.  He  made  a  desperate  attempt  to  stem 
the  current  which  was  sweeping  them  along  ;  his  attention  and 
absorption  .in  business  was  unrelenting  day  and  night,  but  the 
firm  was  too  heavily  handicapped ;  it  was  doomed  to  failure. 

It  is  difficult  now  to  trace  the  site  of  the  forges  and  the 
rolling-mill,  for  the  buildings  themselves  have  long  since  fallen 
to  the  ground.  With  the  aid  of  a  guide,  however,  it  is  possible 
to  see  where  the  different  buildings  stood,  although  now  only 
masses  of  crumbling  stone  mark  the  locations.  The  dam  which 
supplied  the  water-power  gave  way  about  ten  years  ago ;  in 
strength  and  size  it  had  been  the  wonder  of  the  neighborhood. 

Only  portions  of  the  walls  of  one  building  remain.  At 
the  edge  of  the  road,  half-hidden  by  the  dense  foliage  of  the 
surrounding  trees,  stands  a  solitary  stone  wall,  as  solidly  built 
as  the  corner  of  a  prison.  It  is  probably  twenty  feet  high, 
and  forms  one  of  the  corners  of  the  old  charcoal  house,  in- 
closing, probably,  one-half  of  the  building.  In  the  deep  vault, 
still  shadowed  and  hidden  by  this  waU,  was  stored  the  fuel,  from 
time  to  time  as  it  was  needed,  for  the  forges. 

Scattered  over  the  ground  can  still  be  found  large  quanti- 
ties of  iron-slag,  which,  at  the  time  of  the  running  of  the  iron- 
works, had  been  discarded  as  worthless,  being  full  of  fragments 
of  charcoal.  At  that  time  there  was  no  method  to  separate  the 
charcoal  from  the  iron  ;  in  consequence,  tons  of  this  material 
had  to  be  discarded.  Recently,  a  method  was  devised  which 
separated  the  charcoal  from  the  iron,  and  tons  of  this  worthless 
iron-slag  have  been  removed  from  the  place  ;  while  it  lasted,  it 
was  quite  in  demand,  for  it  contained  plenty  of  good  iron. 

Curiously  enough,  the  revolutions  of  time  and  the  require- 
ments of  later  days  render  it  possible  that  this  old,  deserted  site, 
which  marks  the  wreck  of  a  large  fortune,  will  probably  be 
again  the  scene  of  industry.  The  Big  Elk  is  a  valuable  stream 
in  the  manufacture  of  paper,  for  paper-mills  require  water  of  a 
certain  degree  of  purity  with  which  to  wash  their  paper.     In 


DR.    AGNEW'S    BUSINESS    VENTURE.  69 

consequence,  there  lias  sprung  up  on  this  stream  a  number  of 
paper-mills;  the  paper  which  is  used  in  the  Philadelphia  Public 
Ledger  and  the  Philadelj^hia  Record  is  made  on  this  stream, 
not  ten  miles  away. 

Since  the  projection  of  a  new  railroad — the  Lancaster 
Southern — through  this  region,  a  branch  from  the  Baltimore 
and  Ohio,  locating  a  station  within  a  mile  of  this  place,  there 
has  been  good  prospects  of  estabhshing  another  paper-mill  here ; 
so  that  probably  industry  will  again  be  seen  at  this  deserted 
spot,  which,  unless  ruined  by  the  changing  improvements  of 
time,  as  its  predecessor  was,  should  be  eminently  prosperous. 

Dr.  Agnew  felt  keenly  the  failure  of  his  firm,  and,  en- 
dowed with  the  same  sensitive  feeling  of  honor  in  business  as 
Sir  AValter  Scott,  determined  to  make  up  to  his  creditors,  at  the 
earliest  opportunity,  all  that  had  been  lost.  Through  his  ability 
to  do  successful  work  elsewhere,  in  another  line,  he  was  able  to 
pay  back  to  the  creditors  every  cent  of  indebtedness  against 
the  firm. 

This  is  the  simple  story  of  Dr.  Agnew's  venture  into  mer- 
cantile pursuits.  It  has  been  distorted  in  many  particulars,  as 
have  many  other  facts  in  connection  with  his  life. 

Although  it  was  regarded  as  unfortunate  at  the  time  that 
the  firm  should  have  failed,  it  was  the  most  fortunate  thing  that 
it  did  occur,  not  only  for  the  medical  world  and  the  general 
public,  but-also  for  Dr.  Agnew  himself;  for  he  was  undoubtedly 
intended  by  nature  to  do  the  work  which  he  met  subsequently 
in  his  professional  career. 

Durino-  these  vears  of  hard,  unceasins^  toil  it  became  the 
custom  for  Dr.  and  Mrs.  Agnew  to  make  an  annual  pilgrimage 
by  carriage  down  into  Maryland  to  spend  a  few  days  with  his 
parents.  In  these  expeditions  they  were  joined  by  his  half- 
sister  and  her  husband,  Mr.  and  Mrs.  Da  vies  Wallace,  and  their 
daughter,  afterward  Mrs.  Mary  A.  Falls.  It  took  two  days  to 
reach  the  home  of  the  elder  Dr.  Agnew,  in  Baltimore  County, 
but  in  pleasant  weather  it  was  a  beautiful  drive. 


70  LIFE    OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

The  second  evening  found  them  all  at  then*  journey's  end, 
tired  and  hungry,  but  the  elder  Mrs.  Agnew  was  always  ready 
with  her  cheerful  welcome  and  a  steaming  supper  for  their 
comfort.  After  supper  they  talked  over  the  events  which  had 
transpired  since  their  last  union  until  it  was  time  to  retire ;  then 
the  family  Bible  was  brought  out  and  the  Psalm-books.  All 
joined  voice;  if  not  always  in  chord,  at  least  it  was  done  heartily. 
Then  "  Good-night  "  and  "  God  bless  you  "  were  said.  In  the 
morning  the  party  gave  themselves  to  their  enjoyments.  Fre- 
quently the  younger  Dr.  Agnew  would  bring  out  his  violin,  on 
which  he  was  a  skillful  performer,  and  discourse  sweet  music  for 
their  pleasure. 

Those  were  busy  days  for  all.  Dinners  and  suppers  through 
the  region  were  given  for  them ;  all  the  amusements  of  the 
Maryland  country  life  were  brought  into  requisition, — fox-hunt- 
ing, gunning,  and  riding  for  the  men;  dinners  and  visiting  for 
the  women. 

Just  before  the  party  returned  home,  every  one  who  had 
shown  them  attention  was  invited  to  the  house  to  a  bountiful 
dinner,  after  which  the  party  of  children,  now  in  middle  age, 
returned  to  their  Pennsylvania  homes,  just  over  Mason's  and 
Dixon's  Line. 

Feeling  that  he  had  lost  a  number  of  valuable  years  in 
which  he  might  have  been  gaining  practice.  Dr.  Agnew  returned 
again  to  medicine  with  redoubled  energy  and  power.  Con- 
sequently, he  settled  in  Cochranville,  which  was  then  a  flourish- 
ing, growing  village  in  the  central  part  of  Chester  County,  a 
few  miles  south  of  Parkesburg.  He  remained  here  for  seven 
months,  and  his  success  was  most  re-assuring,  although  he  had 
in  the  small  town  a  very  popular  competitor, — a  Dr.  Windall. 

On  his  return  to  medicine  he  determined  to  make  the 
practice  of  surgery  his  life-work.  He  had  long  been  decided  to 
become  a  surgeon ;  in  order  to  do  this,  he  saw  that  it  was 
necessary  to  study  anatomy.  In  consequence,  he  put  into 
action  a  long-cherished  plan  which,  unconsciously,  changed  his 


DR.    AGNEW'S    BUSINESS   VENTURE.  71 

whole  future  life,  and  gave  him  another  wholly  different  career 
from  any  of  which  he  had  yet  dreamed. 

He  began  to  dissect  and  study  bodies  sent  to  him  from 
Philadelphia;  but  it  was  not  long  before  this  anatomical  work 
threw  him  into  bad  repute  with  the  people  of  the  district  in  wliich 
he  lived  ;  the  country  gossips  began  to  criticise  the  young  doctor's 
methods  of  investigation,  and  he  became  much  disliked  in  the 
country  for  the  work  which  was  bringing  his  future  colleague, 
Leidy,  fame  in  the  city. 

This  dislike  for  his  work  among  the  country  people  was  in- 
creased by  several  unfortunate  incidents.  He  was  in  the  habit 
of  employing  a  farmer  to  remove  the  bones  of  his  subjects  to  a 
neighboring  pond,  after  he  had  dissected  the  soft  parts.  This 
pond  was  well  stocked  with  eels,  which  completed  the  work  of 
cleaning  the  bones  for  him, — a  process  all  anatomists  know  to  be 
extremely  slow  and  troublesome  when  done  by  the  dissector.  The 
bones  being  cleaned,  he  was  thus  enabled  to  study  them  carefully. 

At  this  time,  unfortunately,  there  happened  to  be  a  fisher- 
man in  this  region,  who  supplied  the  entire  country  with  the  best 
quality  of  fish  ;  his  eels,  especially,  were  famed  for  their  size  and 
fatness.  There  was  a  flavor  and  a  snap  about  the  eels  which 
this  particular  fisherman  supplied  that  put  despair  into  the 
heart  of  every  other  fisherman  in  the  county.  In  consequence, 
this  fisherman's  reputation  grew, — his  eels  were  in  greater 
demand, — until,  finally,  he  was  hardly  able  to  supply  his  many 
customers  with  this  toothsome  viand.  The  farmer  who  assisted 
Dr.  iVgnew  in  his  anatomical  pursuits  was  among  the  customers 
of  this  prosperous  fisherman.  Working  in  his  field  one  day,  while 
the  fisherrrian  was  passing,  the  farmer  became  curious  to  know 
where  such  magnificent  eels  could  be  found.  "  Well,"  replied 
the  fisherman,  "  if  you  will  promise  to  keep  it  a  secret  where  I  get 
my  eels,  I  will  tell  }ou  ;  I  get  them  from  a  pond  down  here,  on 
your  own  farm."  "  What !  "  cried  the  farmer,  "you  don't  mean 
to  tell  me  that  you  get  them  from  my  pond '? "  It  proved  too 
true  for  the  farmer,  before  whose  unhappy  vision  floated  the 


72  LIFE   OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

memory  of  many  a  hearty  meal  on  these  eels.  When  this  story 
became  known,  it  did  not  increase  the  popularity  of  the  young 
anatomist  to  any  great  extent.  The  neighbors  began  to  inves- 
tigate this  mysterious  pond,  and,  among  other  relics,  fished 
up  a  skull  with  what  they  supposed  to  be  a  bullet-hole  through 
it.  Some  of  the  country  people — possibly  some  of  those  who 
had  partaken  too  bountifully  of  the  eels, — suggested  that  it 
was  some  one  who  had  been  shot  by  this  too  enterprising 
scientist.  Fortunately  for  all  concerned.  Dr.  Agnew  was  able 
to  demonstrate  to  the  community  that  this  mysterious  hole  was 
made  by  a  trephine,  and  was  done  for  practice,  and  not  a  bullet- 
hole  at  all. 

All  these  incidents,  instead  of  discouraging  Dr.  Agnew, 
only  intensified  his  desire  to  get  into  a  wider  field,  where  he 
could  pursue  his  labors  unmolested  by  too  curious  neighbors. 
Naturally,  too,  his  practice  was  seriously  injured.  He  relates 
that  after  the  occurrence  of  these  incidents,  while  driving  along 
the  country  roads,  it  was  no  uncommon  thing  for  the  people  of 
the  district  to  ignore  utterly  his  existence.  He  determined  not 
to  give  up  his  study  of  anatomy,  although  it  rendered  his 
future  most  precarious.  He  had  a  Avife  to  support  and  no  one 
to  aid  him,  yet  he  did  not  turn  back.  Having  at  last  fixed  on 
his  course  of  action,  he  determined  that  nothing  should  deter 
him  from  reaching  the  goal  of  his  ambition. 

He  looked  toward  Philadelphia, — the  seat  of  his  Alma 
Mater, — and  he  decided  to  make  arrangements  to  go  there  to 
carry  out  his  plans. 

In  consequence,  in  the  spring  of  1848  Dr.  Agnew  came  to 
Philadelphia.^  Realizing  the  fact  that  a  physician's  prospects 
are  dependent  somewhat  on  his  location,  he  determined  not  to 
select  his  future  residence  too  hastily ;  in  consequence,  he  lived 
temporarily  with  his  brother-in-law,  AVilliam  Irwin,  on  Filbert 
Street,  west  of  Sixteenth,  at  that  time  a  very  pretty  part  of  the 

1  In  all  previous  accounts  of  Dr.  Aguew's  life  the  time  of  his  coming  to  Philadelphia 
has  been  stated  as  1852,  or  later. 


DR.    AGNEW'S   BUSINESS   VENTURE.  73 

city,  until  he  could  find  a  suitable  residence.  The  summer,  how- 
ever, came  on  before  he  reached  a  decision,  and  at  this  time  Dr. 
Nathaniel  Sample  invited  him  to  return  to  the  country,  to  take 
charge,  temporarily,  of  the  practice  of  his  son,  wlio  had  been 
sick  for  some  time.  Accordingly,  Dr.  Agnew  went  to  Souders- 
burg,  ten  miles  from  Lancaster,  and  spent  the  summer  of  1848 
in  the  country.  He  soon  found  out  that  the  younger  Dr.  Sample 
had  been  sick  so  long  that  his  practice  had  been  scattered,  and 
his  services  were  but  little  in  demand.  He  determined,  how- 
ever, to  take  the  vacation  which  the  opportunity  afforded. 

A  few  years  ago,  meeting  one  of  the  citizens  of  Souders- 
burg.  Dr.  Agnew  said:  "I  located  at  Soudersburg  when  a  young 
man ;  I  stayed  there  long  enough  to  know  all  the  roads  in  that 
district ;  but  I  found  that  the  people  around  there  wanted  a 
better  doctor  than  I  was  hkely  to  prove,  so  I  moved." 

While  here  during  this  summer  there  occurred  an  accident, 
the  effect  of  which  he  carried  to  his  grave,  causing  the  slight 
limp  in  his  gait  wliich  acute  observers  could  always  see.  He 
was  driving  with  Mrs.  Agnew  one  afternoon,  to  visit  some  one  at 
a  distance,  wlien  his  horse  took  fright  at  a  flock  of  sheep  and 
ran  away.  In  turning  a  sharp  corner  in  the  road  the  carriage 
was  flung  violently  around,  and  Dr.  Agnew  was  thrown  to  the 
ground.  Mrs.  Agnew  was  carried  for  some  distance  beyond, 
until,  creeping  over  the  edge  of  the  carriage,  she  dropped  out  at 
the  back,  falling  upon  her  head,  inflicting  a  severe  scalp  wound. 
She  did  not  lose  consciousness,  however,  and,  regaining  her  feet, 
she  returned  to  seek  her  husband.  It  was  nearly  a  mile  beyond 
where  she  had  been  thrown,  but  she  soon  found  him,  stretched 
out  white  and  limp  on  the  porch  of  a  neighboring  house.  She 
quickly  secured  a  vehicle  and  removed  him  to  her  mother's 
home,  where  he  spent  nine  weeks  in  bed.  His  hip  had  been 
very  severely  injured,  and  he  suffered  more  or  less  inconvenience 
from  it  until  the  day  of  his  death.  As  soon  as  he  was  well 
enough  to  return  to  the  city,  they  came  again  to  Philadelphia. 
In  the  meantime,  being  unable  to  select  his  own  location,  and 


74  LIFE    OF    D.    HATES   AGNEW,    M.D.,    LL.D. 

not  wishing  to  delay  any  longer,  he  left  the  decision  to  his  brother- 
in-law.  This  gentleman  selected  a  house  on  Tenth  Street,  above 
Race,  to  which  Dr.  Agnew  came  when  he  had  sufficiently  re- 
covered. The  location  did  not  meet  with  the  approval  of  Dr. 
and  Mrs.  Agnew  at  all,  and  they  determined,  at  once,  to  select 
one  that  would  be  more  congenial,  xiccordingly,  they  took  a 
house,  temporarily,  on  Sixteenth  Street,  below  Arch,  where  they 
stayed  until  they  selected  a  permanent  home,  which  was  at  the 
corner  of  Eleventh  and  Hunter  Streets,  — 16  North  Eleventh 
Street.  At  this  time  this  selection  was  a  very  central  and  excel- 
lent location.  It  was  in  the  best  part  of  the  city,  close  to  the 
best  class  of  practice,  besides  being  within  easy  reach  of  the 
School  of  Anatomy,  in  which  he  spent  later  so  many  hours  a 

day. 

He  had  not  been  forgotten  by  many  old  friends  in  the 
city,  and  he  determined  to  start  to  work  as  quickly  as  possible. 
Deprived  of  his  fortune  by  his  failure,  he  wished  to  find  some- 
thing which  would  at  once  make  him  a  comfortable  living  and 
furnish  him  the  means  of  future  advancement.  He  saw  at 
once  the  advantages  of  such  an  institution  as  the  Philadelphia 
School  of  Anatomy,  which  was  then  rapidly  dwindling  into 
nonentity.  It  was  just  such  a  chance  for  which  he  was  look- 
ing ;  it  afforded  him  a  means  of  support  and  also  a  means  for 
education,  fulfilling  a  two-fold  mission. 

It  is  hard  now,  in  the  lapse  of  years,  at  a  time  when  Dr. 
Agnew  has  become  the  hero  in  surgery  to  the  American  world 
and  his  memory  an  inspiration  to  his  profession,  to  realize  the 
boldness  of  his  course  which  forced  him  eventually  to  Philadel- 
phia. When  he  began  to  dissect  in  the  country,  he  knew  that 
his  course  might  imperil  his  future  there,  but,  once  determined  on 
it,  nothing  could  thwart  him.  His  position  was  not  one  to  which 
such  independence  was  suited.  By  the  failure  of  the  iron-works 
all  his  means  of  sustenance  had  been  given  to  his  creditors ; 
everything  had  been  swept  away.  This  was  the  only  region  in 
which  he  was  well  known,  by  the  memories  of  his  parents,  by 


DR.    AGNEW'S    BUSINESS   VENTURE.  75 

his  own  life-long  friends  and  associates,  and  by  his  wife's  relatives 
and  friends.  He  knew  every  one,  and  by  education  and  temper- 
ament he  was  suited  to  these  people.  In  estranging  them,  he 
was  estranging  relatives  and  friends,  and  at  the  same  time  he 
was  destroying  his  only  means  of  suppoii;  without  increasing, 
apparently,  his  o[)portnnities  elsewhere. 

When  Dr.  and  Mrs.  Agnew  came  to  Philadelphia  they  had 
burned  their  bridges  behind  them,  and  the  future  was  a  vast 
blank  uncertainty.  Dr.  Agnew  did  not  come  as  the  successful 
surgeon  to  fill  the  professorship  at  a  well-known  medical  school; 
nor  did  he  come  with  the  prowess  of  the  discovery  of  some  new 
and  wonderful  advance  in  gynecology,  by  which  a  hitherto 
intractable  disease  was  conquered ;  but  he  came  with  youth, 
health  and  strength,  and  a  determination  to  carry  out  his  line 
of  action. 


CHAPTER  IV. 

Dr.  Agnew's  Connection  with  the  Philadelphia  School 

OF  Anatomy. 

One  of  the  principal  factors  in  the  success  attained  by  Dr. 
Agnew  was  undoubtedly  the  Philadelphia  School  of  Anatomy. 
The  advantages  which  the  training  of  such  a  school  imparts, 
with  the  consequent  reputation  which  is  sure  to  follow  the  suc- 
cessful administration  of  its  affairs,  can  scarcely  be  overesti- 
mated. Philadelphia,  in  many  respects  wonderfully  similar  in 
its  methods  of  life  to  London,  was  like  it  in  the  possession  of 
this  unique  school;  the  English  prototype  being  the  Great 
Windmill  Street  School,  of  London.  This  school,  founded  in 
1770  by  William  Hunter,  which  boasted  such  names  as  the 
Hunters,  Hewson,  Cruikshank,  Baillie,  Wilson,  Brodie,  Bell, 
Shaw,  and  others,  came  to  an  end  in  1833,  after  an  existence 
of  sixty-three  years, — a  period  which  has  been  exceeded  by  its 
American  companion. 

The  Philadelphia  School  of  Anatomy,  established  as  an 
independent  school,  without  the  dignity  or  privileges  of  a  char- 
tered institution,  without  the  prestige  of  the  collection  of  well- 
known  names  as  a  faculty,  without  the  privilege  of  granting 
diplomas  or  degrees,  has  outlasted  many  larger  and  more  pre- 
tentious institutions.  This  school  must  not  be  considered  as  in 
any  sense  a  "quiz  class,"  although  it  performed  some  of  the 
duties  of  a  quiz.  It  was  an  independent  school,  doing  original 
work  in  demonstrations,  teaching,  and  dissections.  It  has 
always  been  remarkable  for  the  character  of  men  it  has  attracted 
as  teachers.  In  nearly  every  instance  of  change  in  its  long  and 
varied  existence,  it  has  depended,  for  its  popularity  and  useful- 
ness, more  or  less  upon  the  ability  and  reputation  of  one  man. 

The  undertaking  of  such  a  school  meant  the  greatest  risks 
to  a  medical  teacher,  but  it  also  included  the  greatest  prospects 
(76) 


DR.    AGNE\7   IN    THE    SCHOOL    OF    ANATOMY.  77 

of  success.  Failure  meant  financial  loss  as  well  as  the  acknowl- 
edgment of  defeat,  undoubtedly  closing  further  avenues  of  ad- 
vance in  the  line  of  medical  teaching.  Success,  on  the  other 
liand,  meant  the  gathering  of  a  large  class  of  enterprizing  and 
enthusiastic  students, — the  most  congenial  happiness  in  the 
world  to  a  real  teacher.  It  meant,  also,  considerable  financial 
return ;  but,  iar  more,  it  opened  quickly  and  thoroughly  future 
prospects.  It  attracted  attention  from  all  quarters.  The  school 
stood  as  a  stepping-stone  to  professorships  in  the  regular  medical 
colleges.  This  is  shown  by  the  fact  that  nearly  every  teacher 
who  left  the  School  of  xA.natomy  was  called  to  some  important 
professorial  position.  It  also  meant  the  rapid  distribution  of 
pupils  throughout  the  country,  with  the  consequent  growth  of 
consultation  practice.  In  short,  the  Philadelphia  School  of 
Anatomy  could  be  an  element  for  great  good,  or  for  great  evil, 
in  the  hands  of  its  teachers. 

The  successful  prosecution  of  a  school  of  the  style  of  the 
Philadelphia  School  of  Anatomy  was  dependent  upon  a  number 
of  factors.  It  required  the  immediate  presence  of  several  large 
medical  schools  from  which  it  could  draw  its  students.  In  ad- 
dition, to  this,  it  implied  a  lack  of  strength  in  the  dissecting 
courses  of  these  regular  chartered  institutions,  for  it  showed  that 
the  attractions  of  the  school  were  greater  than  the  attractions  of 
the  colleges.  At  the  height  of  its  prosperity  it  was  the  custom 
for  the  medical  schools  in  Philadelphia  to  charge  each  student 
for  each  branch  in  which  he  received  instruction,  and  lience 
many  students  preferred  to  receive  their  anatomical  education 
at  this  school ;  students  being  permitted  by  the  authorities  of 
the  various  colleges  to  do  their  dissecting  wherever  they  desired. 
This  gave  the  opportunity  for  opening  such  a  school.  Subse- 
quently, this  privilege  was  withdrawn ;  but  even  after  tlie  with- 
drawal of  this  privilege  the  school  held  its  usual  attendance. 

With  the  removal  of  the  Medical  Department  of  the  Uni- 
versity to  -West  Philadelphia,  with  the  strengthening  of  the 
Jefferson  Medical  College  and   the  Dental  Colleges,  however. 


78  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

such  a  school  must  necessarily  deteriorate.  It  is  no  criticism  on 
the  later  teachers  of  anatomy  in  this  school  to  say  that  the  im- 
portance of  this  institution,  as  an  independent  educational  factor 
in  Philadelphia  medical  circles,  has  become  less.  The  conditions 
of  medical  teaching  are  so  different  at  the  present  time  that 
this  is  a  natural  sequence. 

The  demonstrations  of  anatomy  and  the  dissecting  which 
were  done  in  this  school  were  intended  to  be  eminently  practical 
in  their  nature.  While  it  was  the  intention  of  the  lecturers  to 
present  anatomy  in  as  scientific  and  thorough  a  manner  as 
possible,  at  the  same  time  the  subject  was  taught  for  use  to 
practising  physicians.  The  work  done  by  Dr.  Leidy  at  the 
University  of  Pennsylvania,  and  that  done  by  Dr.  Agnew  at  this 
school,  stand  out  as  typical  examples  of  the  two  great  methods 
of  teaching  anatomy.  Dr.  Leidy  dissected  as  the  eminent  sci- 
entist, whose  vast  knowledge  of  comparative  anatomy  and  its 
allied  branches  was  constantly  drawn  on  for  record  and  com- 
parison. On  the  other  hand.  Dr.  Agnew  dissected  as  the 
practical  surgeon,  whose  intention  it  was  to  use  his  knowledge 
of  anatomy,  and  teach  others  to  use  theirs,  for  operating.  With 
that  clearness  which  marked  his  entire  life-work,  he  saw,  when 
he  knowingly  incurred  a  second  defeat  in  the  country,  that 
anatomy  is  the  mother  of  successful  surgery,  and  he  became  the 
the  great  anatomist  in  order  to  become  the  great  surgeon.  He 
went  so  far  in  this  belief  as  to  state  tliat  he  believed  a  surgeon 
could  not  become  pre-eminent  unless  he  had  spent  a  number  of 
years  in  the  actual  demonstration  of  practical  anatomy. 

This  school,  which  stands  unique  in  medical  history  in  this 
country,  was  opened  in  March,  1820,  as  the  private  anatomical 
school  of  Dr.  Jason  Valentine  O'Brien  Lawrance,  under  the 
title  of  the  "Philadelphia  Anatomical  Rooms."  It  started  at 
the  location  at  which  it  stood  for  fifty-five  years,  at  the  upper 
end  of  Chant  Street,  which  was  then  called  College  Avenue. 
The  building  in  which  the  school  was  carried  on  stood  on  the 
north  side  of  the  street.     At  various  times  the  building  adjoin- 


The  PuiLAnKLPniA  School  of  Anatomy. 


DR.    AGNEW    IN    THE    SCHOOL    OF    ANATOMY.  79 

inii"  to  the  westward  was  utilized  in  addition.  It  remained  in 
this  location  until  1875,  when  the  government  took  the  ground 
on  which  the  easternmost  building  stood  as  a  portion  of  the  site 
for  the  new  post-office. 

The  location  of  the  School  of  Anatomy,  as  selected  by  Dr. 
Lawrance,  was  an  excellent  one.  It  was  within  a  stone's  throw 
of  the  University  of  Pennsylvania,  and  it  happened  also  to  be 
close  to  the  Jefferson  Medical  College,  which  was  started  at  a 
later  date.  When  the  government  seized  the  eastern  building, 
as  a  portion  of  the  site  for  the  new  post-office,  it  left  the  other 
building  untouched.  It  stands  to-day,  a  solitary  and  deserted 
memorial  of  the  former  school.  It  is  unchanged  in  appear- 
ance, and  the  old  sign,  which  can  be  seen  on  the  left-hand  side 
of  the  illustration,  still  remains. 

At  the  beginning  of  the  present  century,  in  Philadelphia, 
it  was  the  custom  of  well-known  physicians  to  have  private  dis- 
secting-rooms for  their  office  pupils,  not  depending  entirely  upon 
the  anatomical  rooms  of  the  University  of  Pennsylvania.  In 
1818  Dr.  Joseph  Parrish  opened  a  private  dissecting-room  in 
the  rear  of  Christ  Church,  and  in  1822  Dr.  Thomas  T.  Hew- 
son  opened  another  over  his  stable  on  Library  Street,  next  door 
to  the  present  Custom  House,  removing  it  subsequently,  in 
1829,  to  Blackberry  Alley,  in  the  rear  of  his  house  on  Walnut 
Street,  above  Ninth.  Dr.  George  McClellan  had  another  pri- 
vate dissecting-room  on  Sansom  Street  above  Sixth,  and  a  fourth 
existed  on  Eighth  Street  above  Jayne,  which  was  then  called 
Lodge  Alley. 

All  of  these  schools  differed  from  the  Philadelphia  School 
of  Anatomy,  in  that  they  were  ephemeral  in  character,  and  were 
intended  principally  for  the  instruction  of  the  office  students  of 
their  proprietors ;  while  Lawrance,  on  the  other  hand,  opened 
his  school  for  all  who  cared  to  come,  and  so  established  an  in- 
stitution which  has  educated  thousands  of  students  and  scores 
of  teachers  for  their  life-work.  Tradition  says  that  Lawrance 
was  an  unusually  brilliant   teacher.      He  was  born   in  Xew 


80  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

Orleans  in  1791,  and  graduated  at  the  University  of  Pennsyl- 
vania in  1815.  He  returned  to  New  Orleans,  and  began  the 
practice  of  medicine  there,  but,  thirsting  for  the  advantages  he 
had  found  hi  Philadelphia  during  his  student  life,  he  returned 
in  1818,  and  at  once  resumed  his  scientific  labors.  At  that 
time  the  University  of  Pennsylvania,  which  was  then  the  only 
medical  school  in  Philadelphia,  closed  its  doors  from  April  until 
November. 

To  fill  out  this  long  vacation  Lawrance  gave  a  course  on 
anatomy  and  surgery,  which  began  in  March,  had  a  recess  in 
August,  and  ended  in  November.  He  gave  six  lectures  a  week, 
and  his  personal  qualities,  as  well  as  the  ease  and  clearness  of 
his  style  as  a  lecturer,  made  his  school  a  decided  success.  In 
the  fall  of  the  same  year  he  became  assistant  to  Dr.  Gibson,  who 
was  then  Professor  of  Surgery  in  the  University,  and  in  1822  he 
was  also  made  assistant  to  Dr.  Horner,  then  Adjunct  Pro- 
fessor of  Anatomy.  He  was  also  surgeon  to  the  Philadelphia 
Hospital.  He  did  not  live  long  to  conduct  his  school,  for,  while 
attending  the  poor  in  the  Pidge  Poad  district,  during  an  epi- 
demic of  typhus  fever  in  the  summer  of  1823,  he  was  attacked 
by  the  disease  and  died,  at  the  age  of  32. 

Dr.  Lawrance  was  a  diligent  writer;  he  left  behind  him 
over  three  thousand  pages  of  unpublished  manuscript,  much  of 
it  intended  for  use  in  a  projected  work  on  pathological  anatomy, 
— a  subject  then  very  much  neglected  in  America.  After  Dr. 
Lawrance's  death  the  school  passed  into  the  liands  of  Dr.  John 
D.  Godman.  Dr.  Godman  was  also  from  the  South,  bavins: 
been  born  in  Annapolis  in  1794.  He  studied  medicine  at  the 
University  of  Maryland,  and  soon  after  his  graduation,  in  1821, 
he  was  appointed  Professor  of  Anatomy  in  the  Medical  School 
of  Ohio.  He  came  to  Philadelphia  in  1822,  retiring  from  practice 
in  1823,  when  he  began  to  teach  in  the  Anatomical  School. 
The  first  winter  he  had  a  class  of  seventy  students.  As  was  the 
custom  for  many  years  afterward,  he  gave  three  courses  a  year, 
viz. :   The  autumn  course,  twice  a  week,   from   September  to 


DR.    AGXEW    IN    THE    SCHOOL    OF    ANATOMY.  81 

November ;  the  winter  course,  four  times  a  week,  from  Novem- 
ber to  March ;  and  the  spring  course,  twice  a  day,  witli  a  view 
to  graduation,  from  March  1st  to  April  1st,  the  remainder  of  the 
year  being  a  vacation  from  teaching,  but  devoted  to  work.  The 
fee  was  $10,  the  same  as  it  was  later,  although  but  two  annual 
courses  were  given  subsequently,  lasting  from  October  to  March 
and  xA.pril  to  October,  with  a  recess  hi  July  and  August. 

Dr.  Godman's  lectures  were  characterized  by  simplicity  of 
language,  directness  of  statement,  and  fertility  of  illustration. 
It  was  his  invariable  habit  to  dissect  before  the  class  while  he 
lectured,  no  previous  dissection,  however  incomplete,  having  been 
made, — a  method  which  was  only  practical  before  the  introduc- 
tion of  the  use  of  chloride  of  zinc,  which  hardens  the  tissues  too 
much  for  such  rapid  work.  He  frequently  used  bodies  for 
dissection  which  were  in  quite  advanced  stages  of  putrefaction. 

In  182-1  he  established  in  the  school  a  reading-room  sup- 
plied with  text-books  and  journals,  and,  not  long  after,  he  in- 
tended to  enlarge  the  sphere  of  the  school  by  adding  associate 
lecturers.  Accordingly,  he  invited  Dr.  R.  E.  Griffiths,  after- 
ward of  the  University  of  Virginia,  to  lecture  on  practice  and 
materia  medica,  and  Dr.  Isaac  Hays  on  surgery  and  the  eve, 
lecturing  himself  on  anatomy  and  surgery.  This  programme 
was  never  carried  out,  however,  for  in  1826  the  widely-spread 
fame  of  Dr.  Godman  had  called  attention  to  him  so  prominentlv 
that  he  was  called  to  the  Chair  of  Anatomy  in  Rutgers  Medical 
College,  then  established  in  New  York  City.  Unfortunatelv, 
his  health  broke  down  during  his  second  course  at  this  school, 
and,  after  vainly  traveling  in  search  of  health,  he  settled  in 
Germantown,  where  he  died  in  1830.  He  also  \\as  a  volumi- 
nous writer.  In  1825  he  became  one  of  tlie  editors  of  the 
Philadelphia  Journal  of  the  Medical  and  Physical  Sciences^ 
which  was  enlarged  in  1827,  by  tlie  agreement  that  the  profes- 
sion in  New  York  would  support  the  journal  if  it  dropped  its 
local  name,  wliich  it  did,  becoming  the  American  Journal  of 
the  Medical  Sciences. 


82  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

When  Dr.  Godman  went  to  Rutgers  College,  in  1826,  he 
was  succeeded  by  Dr.  James  Webster.  Dr.  AVebster  retamed 
the  school  for  four  years,  when,  m  1830,  he  was  called  to  the 
Chair  of  Anatomy  in  the  Geneva  Medical  College.  Although 
not  so  polished  a  man  nor  so  industrious  a  worker  as  Godman, 
he  was  an  excellent  teacher  and  a  good  anatomist.  He  was 
thoroughly  devoted  to  the  interests  of  his  class,  and  when  there 
was  greater  difficulty  than  usual  in  getting  subjects, — a  chronic 
complaint  in  dissecting-rooms, — he  sat  up  night  after  night  to  see 
that  neither  the  University  nor  any  private  room  should  obtain 
them  until  he  was  supplied.  After  Dr.  Webster  left  the  school 
its  doors  remained  closed  for  a  year,  making  the  only  break  in 
its  history  until  1875. 

In  1831  Dr.  Joseph  Pancoast  reopened  the  rooms,  three 
years  after  his  graduation  from  the  University  of  Pennsylvania, 
and  in  the  seven  years  which  he  spent  in  lecturing  and  work- 
ing here  he  laid  the  foundation  of  his  subsequent  career  as 
anatomist  and  surgeon.  He  gave  the  usual  three  annual  courses 
which  Godman  had  established,  but  no  other  lectures  were  given 
in  the  building  during  his  administration.  In  1838,  following 
the  usual  custom  of  the  teachers  in  this  school,  he  went  to  Jef- 
ferson Medical  College  as  Professor  of  Anatomy,  in  which  posi- 
tion he  won  world-wide  fame.  After  Dr.  Pancoast  was  elected 
to  Jefferson  Medical  College  he  was  succeeded  by  Dr.  Justus 
Dunott,  who  lectured  in  the  school  alone  for  about  three  years. 

Until  1839  the  "Philadelphia  Anatomical  Rooms"  con- 
sisted solely  of  the  east  building,  the  adjacent  structure  con- 
taining a  carpenter-shop  and  warehouse;  but  in  1839  the  two 
buildings  contained  rival  schools,  for  Dr.  James  McClintock  then 
rented  and  fitted  up  the  western  building  as  a  lecture-room.  Dr. 
McClintock  had  started  a  dissecting-room  the  year  before  at  the 
southeast  corner  of  Eighth  and  AValnut  Streets,  and  called  it  the 
"  Philadelphia  School  of  x\natomy  "  ;  this  was  the  first  time  this 
title  had  been  used  by  any  school.  His  neighbors  complained 
so  vigorously  to  him,  on  account  of  the  odor  coming  from  his 


DR.    AGNEW    IN    THE    SCHOOL   OF    ANATOMY.  83 

rooms,  tliat  Dr.  McClintock  moved  to  Chant  Street,  next  door 
to  the  older  school.  Here  he  gathered  a  very  large  class  by 
his  brilliant  demonstrations,  remaining  here  until  1841,  when 
he  was  elected  Professor  of  Anatomy  in  the  Vermont  Academy 
of  Medicine,  afterward  called  the  Castleton  Medical  College. 
He  was  succeeded  by  Dr.  Jonathan  M.  Allen,  who  had  been  a 
former  office  pupil  and  subsequently  his  assistant.  Dr.  Allen 
joined  forces  with  Dr.  Dunott,  after  Dr.  McClintock's  removal 
from  the  city,  and  they  occupied  both  buildings,  taking  the  new 
title  of  the  "  Philadelphia  School  of  Anatomy." 

It  has  been  claimed,  by  good  authority,  that  Dr.  McClin- 
tock founded  the  Philadelphia  School  of  Anatomy.  This  state- 
ment is  a  mistake.  He  founded  a  school  which  he  called  the 
"  Philadelphia  School  of  Anatomy,"  and  which  was  subse- 
quently merged  into  the  older  school,  giving  it  its  new  title ;  but 
by  the  Philadelphia  School  of  Anatomy  is  meant,  undoubtedly, 
the  original  school  which  was  established  in  Chant  Street  in 
1820  by  Dr.  Lawrance,  and  which  stood  on  that  site  for  fifty- 
five  years.  The  title,  "  Philadelphia  Anatomical  Pooms,"  clung 
for  many  years  as  an  explanatory  sub-title.  Shortly  after  this 
Dr.  Allen  was  left  in  sole  charge  of  the  school. 

In  1842  Dr.  William  P.  Grant,  who  had  been  Demonstrator 
of  Anatomy  at  Jefferson  Medical  College,  held  the  western 
building  for  a  year,  when,  becoming  Professor  of  Anatomy  and 
Physiology  in  the  Pennsylvania  Medical  College,  he  relinquished 
it  to  Dr.  McClintock,  who  returned  to  Philadelphia  and  occupied 
the  western  building  again,  from  1843  to  1847. 

In  1844  Dr.  McClintock  enlarged  his  school,  having  lec- 
tures on  practice  by  Dr.  James  X.  McCloskey,  and  on  materia 
medica  by  Dr.  Jackson  Van  Stavern.  Dr.  McClintock  in  1847 
secured  the  charter  of  the  Philadelphia  Medical  College,  and 
left  the  School  of  Anatomy.  From  1847  to  1852  Dr.  Allen 
assumed  control  again  of  both  buildings.  At  this  latter  date  he 
also  left  the  school  forever,  being  elected  Professor  of  Anatomy  at 
the  Pennsylvania  Medical  College.     One  incident  is  remarkable 


84  LIFE    OF    D.    HATES   AGNEW,    M.D.,    LL.D. 

to  note  which  occurred  during  his  administration:  a  woman 
dissected  in  the  school  as  a  medical  student,  probably,  for  the 
first  time, — the  date  being-  1843  or  1844.  During  the  early 
part  of  tills  decade  the  school  received  its  most  famous  scholar 
of  anatomy,  Dr.  Joseph  Leidy.  He  was  a  pupil  here  for  some 
time  during  the  regime  of  Dr.  McClintock. 

Dr.  Allen  was  succeeded  by  Dr.  Agnew  in  1852,  who 
held  the  responsibility  of  the  school  for  ten  years.  When  he 
entered  the  school,  as  he  has  stated  in  one  of  his  addresses, 
"  that  single  front  bench  afforded  ample  accommodations  for  my 
audience."  This 'was  strictly  true,  for  the  records  of  the  school 
show  that  there  were  but  nine  students  when  he  began  lecturing 
there.  For  many  long  years  he  toiled  patiently  and  unceasingly, 
spending  from  twelve  to  eighteen  hours  a  day  in  the  dissection 
of  that  marvelous  human  structure  which  he  learned  to  know 
so  well.  His  industry  during  these  years  may  be  judged  by 
the  fact  that,  in  addition  to  his  dissections  and  practical  work, 
he  lectured  five  evenings  a  week  from  September  1st  to  March 
1st,  and  three  times  a  week  from  April  1st  to  August  1st.  The 
school  naturally  prospered,  until  he  was  obliged  to  enlarge  its 
capacity,  throwhig  the  small  room  on  the  third  story  into  the 
'  lecture-room,  to  accommodate  the  throngs  of  students  who 
gathered  to  see  and  hear  his  lucid  demonstrations.  In  1854 
Dr.  Agnew  altered  the  second  story  of  the  eastern  building,  and 
started  the  Philadelpliia  School  of  Operative  Surgery,  in  which 
his  classes  were  also  large.  While  teaching  here  he  published 
his  "  Dissector's  Manual,"  his  lecture  on  the  "  Career  of  Baron 
Larrey,"  a  valued  and  prolonged  series  of  papers  in  the  Medical 
and  Surgical  Reporter,  o\\  the  "Relations  of  Anatomy  to 
Surgery  and  Medicine,"  and  prepared  a  work  on  the  "  Fasciae 
of  the  Human  Body,"  which,  however,  he  never  published. 

As  the  school  grew  in  size  and  importance,  Dr.  Agnew 
found  it  necessary  to  add  demonstrators  of  anatomy  to  assist 
him  in  his  work.  Drs.  R.  J.  Barclay  and  J.  R.  Sanderson  were 
his  demonstrators  from  1857  to  1859.     Later,  they  were  Drs.  R. 


DR.    AGNEW   IN    THE    SCHOOL    OF    ANATOMY.  85 

J.  Levis,  William  Flynn,  J.  K.  Kane,  and  Morris  J.  Asch  ;  in 
1860  they  were  five  in  number,  Drs.  R.  J.  Levis,  William  Flynn, 
1).  R.  llichardson,  J.  T.  Darby,  and  Robert  Boiling.  Later, 
Drs.  James  E.  Garretson,  John  W.  Lodge,  and  S.  W.  Gross  ^ 
were  added  to  this  number. 

The  duties  of  a  demonstrator  of  anatomy,  during  Dr. 
Agnew's  administration  of  the  school,  consisted  in  being  present 
each  evening,  in  the  dissecting-room,  to  aid  the  students  in  their 
dissections,  and  to  demonstrate  the  different  regions  of  the  body. 
The  only  remuneration  which  they  received  was  the  advantage 
of  constantly  reviewing  their  knowledge  of  anatomy,  and  the 
opportunity  of  practising  ligations  and  studying  accurately  the 
parts  involved  in  hernia,  tracheotomy,  etc.,  together  with  the 
privilege  of  attending  all  the  lectures  delivered  by  Dr.  Agnew 
free  of"  charge. 

During  each  winter  course  Dr.  Agnew  met  his  students 
one  hundred  and  thirty  evenhigs  to  discuss  the  high  theme  of 
God's  master-piece  of  handiwork.  He  began  the  teaching  of 
anatomy  by  a  study  of  the  constituent  elements  of  the  body, 
which  was  followed  by  a  study  of  the  subject  of  osteology  and 
syndesmology,  m  which,  as  Dr.  Agnew  humorously  stated,  his 
"  students '  thoughts  often  embodied  the  language  of  the 
prophet:  'And,  lo,  they  were  very  dry.'  "  Next  came  a  study 
of  the  apparatus  of  locomotion,  which  included  the  muscular 
system  ;  then  the  organs  performing  the  functions  of  digestion  ; 
then  the  organs  of  circulation  and  respiration,  and,  finally,  tlie 
organs  of  special  sense. 

The  School  of  Operative  Surgery  was  totally  distinct  from 
the  School  of  Anatomy.  On  usually  two,  and  sometimes  three, 
evenings  a  week,  this  special  class  for  operative  surgery  met. 
On  these  evenings,  lectures  were  given  to  explain  the  surgical 


^  By  a  typographical  error,  Dr.  Agnew  was  made  to  state  in  an  address  that  Dr.  S. 
D.  Gross  was  his  demonstrator ;  the  incorrectness  of  this  statement  is  manifest,  for  Dr.  S.  D. 
Gross,  besides  being  a  much  older  man  than  Dr.  Agnew,  was  Professor  of  Surgery  at  the 
Jeflerson  Medical  College  at  this  time. 


86  LIFE    OF   D.    HAYES    AGNEW,    M.D.,    LL.D. 

anatomy  of  the  different  regions,  illustrated  with  drawings, 
skeletons,  wet  and  dry  preparations,  etc.  ;  for  example,  first 
would  be  studied  the  surgical  anatomy  of  the  femoral  artery ; 
next,  the  various  points  at  which  it  could  be  ligated,  with  the 
advantages'  and  disadvantages  of  each,  and  the  description  of 
the  actual  steps  of  each  operation.  Then  each  class  of  five 
went  to  its  own  table  with  its  own  assistant  demonstrator, 
and,  if  the  operation  was  on  the  common  femoral  artery,  the 
superficial  femoral  in  Scarpa's  triangle  and  in  Hunter's  canal 
were  then  divided  amongst  the  class,  according  to  a  "table  of 
operations."  When  three  operations  could  be  done  on  each 
side  of  each  artery,  there  were  more  than  enough  to  go  round ; 
when  a  single  operation  could  be  done,  such  as  in  tracheotomy, 
or  two,  as  in  ligation  of  the  subclavian  artery,  they  were  appor- 
tioned equitably  among  the  difl'erent  members  of  the  class. 
The  length  of  the  course  in  operative  surgery  was  about  sixteen 
sessions,  of  two  hours  each ;  but  the  course  was  always  con- 
tinued until  all  the  operations  feasible  on  a  cadaver  had  been 
done.  Some  classes  worked  more  rapidly  than  others.  The 
number  of  students  ran  from  six  to  eight  or  ten  classes,  of  five 
each. 

The  students  came  from  the  University  of  Pennsylvania, 
Jefi'erson  and  Pennsylvania  Medical  Colleges,  and  the  Dental 
Colleges,  to  attend  this  course  of  instruction  on  general,  special, 
and  surgical  anatomy;  so  that  Dr.  Agnew's  students  were  by  no 
means  confined  to  one  school. 

There  are  many  hundreds  of  graduates  of  Jefi'erson  Medical 
College  who  justly  and  proudly  claim  that  they  were  students  of 
Dr.  Agnew. 

So  crowded  did  the  lecture-room  become,  under  Dr.  Agnew's 
administration,  that  it  was  necessary  to  arrive  in  good  time  in 
order  to  get  a  satisfactory  seat.  As  these  lectures  were  given  in 
the  evening,  so  as  not  to  interfere  with  the  courses  of  instruction 
at  the  medical  colleges,  many  were  the  cases  of  dyspepsia  among 
the  students,  who  hurried  through  their  evening  meal  on  this 


DR.    AGNEW    IN    THE    SCHOOL    OF    ANATOMY.  87 

account.  Tlie  classes  increased  each  year  until  they  averaged 
in  size  about  two  liundred  and  seventy  students.  The  school 
was  limited  to  this  number  only  by  the  size  and  capacity  of  its 
buildings ;  if  the  accommodations  had  been  larger,  the  classes 
would  have  been  much  larger. 

Dr.  Agnew  ins})ired  his  students  with  an  interest  in  the 
difficult  and  dry  subject  which  he  taught ;  so  that  many  who 
entered  the  old  Chant  Street  school  became  zealous  and  earnest 
workers,  and  in  after  years  did  honor  to  their  grand  old  master 
by  becoming  themselves  distinguished  anatomists  and  surgeons. 

Dr.  Agnew  lectured  every  evening  except  Saturday  and 
Sunday,  making  five  lectures  a  week  for  six  months,  averaging 
one  hundred  and  thirty  lectures  in  each  winter  course ;  in  the 
spring  and  summer  course  he  delivered  lectures  three  times  a 
week  for  four  months.  As  there  are  but  three  hundred  and 
thirteen  working  days  in  the  year,  it  will  be  seen  that  Dr. 
Agnew,  in  delivering  one  hundred  and  eighty  lectures,  lectured, 
on  an  average,  oftener  than  once  every  other  day  for  the  entire 
year.  Of  course,  these  lectures  were  in  addition  to  his  dissec- 
tions and  practical  work.  As  Dr.  Agnew  was  connected  with 
the  school  for  over  ten  years,  he  delivered  over  eighteen  liundred 
lectures ;  the  lectures  in  the  eleventh  year  not  being  counted  to 
offset  the  few  appointments  which  he  did  not  keep. 

The  lecture-room  of  the  School  of  Anatomy  was  built  in 
imitation  of  the  ordinary  lecture-room  of  a  medical  college.  It 
had  tier  above  tier  of  benches,  rising  so  abruptly  above  each 
other  that  the  seventh  or  highest  row  was  fully  twenty  feet  above 
the  arena.  It  may  be  interesting  to  those  who  have  sat  for 
hours  upon  the  ordinary  clinique-room  bench,  which  seems 
always  to  be  made  of  boards  particularly  unyielding  in  their 
texture,  to  know  that  these  benches  were  covered  with  cushions. 
This  unparalleled  luxury  was  the  only  portion  of  the  "  royal  road 
to  learning  "  reached  by  the  embryo  anatomists  of  Chant  Street. 
In  the  arena  was  a  revolving  table  on  which  the  cadaver  to 
be  demonstrated  could  be  placed.     Over  this  was  a  series  of 


88  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

lights,  SO  arranged  as  to  throw  their  illumination  over  the  lec- 
turer and  the  subject.  Hanging  in  mid-air,  by  a  wire  from  the 
ceilins:,  was  a  skeleton,  which  could  be  lowered  when  needed. 
On  a  shelf  back  of  the  lecturer  stood  a  number  of  statues,  repre- 
senting, classically,  the  human  form.  One  was  a  representation 
of  Hercules,  another  of  Mercury,  a  third  of  Venus,  and  a  fourth 
"  The  Discus  Thrower,"  This  room  was  surprisingly  similar  in 
appearance  to  the  well-known  quiz-room  of  the  Medical  Insti- 
tute, now  at  3451  "Woodland  Avenue,  Philadelpliia. 

The  dissecting-room  was  above,  in  a  long,  low  apartment 
in  the  third  story.  This  room  is  the  only  trace  left  of  the  old 
school,  being  situated  in  the  western  building,  which  still  stands. 
Careful  search  shows  that  the  rest  of  the  building  has  been 
completely  altered. 

A  curious  character  which  is  found  in  every  medical  school 
is  the  janitor  of  the  dissecting-room.  He  always  has  an  air  of 
better  davs ;  he  is  extremely  stoical  and  cynical  in  his  work  ;  and 
he  always  commands  respect  among  the  students  on  account  of 
the  many  stories  of  his  Avonderful  ability  as  a  hard  drinker. 
That  the  janitor  of  tliis  date  was  of  this  kind  is  shown  in  a  reso- 
lution passed  by  the  class  in  1857.  At  a  stated  meeting  of  the 
class,  held  during  the  winter  of  1857-58,  it  was  resolved  "That 
in  justice  to  the  merits  of  our  faithful  janitor,  John  Campbell, 
we  are  compelled  to  say  that,  as  the  genius  of  the  anatomical 
rooms,  he  must  be  known  to  be  appreciated." 

During  the  winter  of  1854-55  Dr.  Agnew  became  seriously 
ill,  as  the  result  of  a  wound  received  while  making  an  autopsy 
on  a  woman  who  had  died  of  peritonitis.  He  was  ill  for  some 
time,  and  during  that  period  Dr.  William  Goodell  took  charge 
of  the  school,  supervising  the  dissections  made  by  the  students. 

Throuo-h  Dr.  Ao:new's  administration  of  affairs  at  the 
School  of  Anatomy,  the  subject  of  the  supply  of  material  was 
always  a  difficult  one.  It  was  necessary  for  him  to  be  constantly 
on  tlie  outlook  to  obtain  bodies  for  his  students'  use,  but  he 
obtained   them    in  a  perfectly  legitimate   way ;    for   example, 


DR.    AGNEW   IN    THE    SCHOOL    OF    ANATOMY.  89 

during  the  terrible  epidemic  of  Asiatic  cliolem  in  Philadelphia, 
in  1854:,  there  were  so  many  deatiis  daily,  at  the  Philadelphia 
Hospital,  that  deep  pits  were  dug  in  the  neighboring  fields,  into 
which  the  bodies  were  rudely  thrown.  xVt  that  time,  in  order 
to  render  these  bodies  suitable  for  use,  Dr.  Agnew  would  de- 
scend into  these  pits,  and,  with  the  sun  beating  fiercely  upon 
his  head,  he  would  inject  a  sufficient  number  of  bodies  for  his 
purpose. 

Obtaining  proper  material  for  dissection  is  a  source  of  diffi- 
culty, in  the  management  of  a  dissecting-room,  which  is  rarely 
brought  to  the  attention  of  the  public.  This  question,  which 
has  now  been  settled  legally, — a  regular  supply,  through  proper 
channels,  being  portioned  to  the  different  medical  schools  of 
the  country,  from  the  proper  officials, — has  been,  in  times  gone 
by,  a  very  burning  consideration.  From  the  days  when  Vesalius 
was  compelled  to  spoil  the  gallows  of  its  victims,  hiding  the 
bodies  even  in  his  own  bed ;  when  Sir  Astley  Cooper  barely 
escaped  mobbing  for  the  same  offense ;  and  Dr.  Shippen  was 
assaulted  in  Philadelphia,  in  1765,  by  a  mob,  for  the  same 
reason,  it  can  be  seen  that  this  forms  another  unpleasant  phase 
of  the  already  hard  lot  of  the  demonstrator  of  anatomy. 

The  increase  of  the  demand  for  bodies  which  came  with 
the  advance  of  medicine,  with  the  lack  of  supply  which  existed 
until  within  recent  years,  resulted  in  the  production,  especially 
in  England,  of  a  class  of  people  known  as  "  Resurrectionists." 
These  body-snatchers  became  so  expert  at  their  work  that  they 
could  rob  a  grave  in  very  short  order.  The  demand  became  so 
great,  and  the  price  so  much  higher,  that  finally  the  victims 
were  even  selected  from  among  the  living,  and  were  murdered, 
in  order  that  they  might  be  sold  to  the  dissecting-rooms.  The 
infamous  crimes  of  William  Burke,  in  Edinburgh,  arc  anions: 
the  most  interesting  in  criminal  annals.  This  man  killed  a 
number  of  persons,  in  order  to  sell  their  bodies  to  the  local  dis- 
secting-rooms. Similar  instances  occurred  elsewhere,  until  the 
authorities,  aroused  to  the  necessity  of  regulating  this  question, 


90  LIFE    OF   D.    HATES   AGNETT,    M.D.,    LL.D. 

passed  the  "  Anatomy  Acts."  In  England,  the  Warburton 
Anatomy  Bill,  enacted  in  1832,  gave  all  unclaimed  bodies, 
under  certain  regulations,  to  the  various  schools.  This  was 
followed  by  the  passage  of  similar  acts  in  this  country/ 

The  great  mass  of  ignorant  people  are  so  slow  in  ac- 
quiring, their  knowledge,  being  generally  about  a  hundred  years 
behind  the  times,  that  it  is  a  common  belief,  among  many  of 
this  strata  of  society,  that  the  authorities  of  certain  hospitals 
murder  their  patients  in  order  that  they  may  be  dissected  by 
medical  students.  The  Philadelphia  Hospital  has  a  great 
reputation  for  this  thing  among  the  negroes  of  the  city;  they 
believe  firmly  that  when  they  go  to  this  hospital  they  need 
never  expect  to  come  back  alive.  In  consequence,  it  is  only  as 
a  last  resort  that  they  apply  for  admission  to  this  institution. 

This  ignorant  belief,  curiously  enough,  is  heightened  by 
some  of  the  conditions  of  admission  in  the  hospital  rules.  This 
hospital  is  the  only  regular  hospital  in  the  city  which  will  take 
any  large  number  of  chronic  cases.  Consequently,  when  a 
negro  falls  sick  with  pneumonia,  he  can  go  to  the  Pennsylvania 
Hospital,  where,  as  a  rule,  he  recovers ;  but,  if  he  contracts 
consumption,  he  applies  in  vain  at  every  other  hospital,  until 
he  is  at  death's  door,  when  he  is  forced  into  the  Philadelphia 
Hospital,  from  which  his  non-appearance  alive  is  only  confirma- 
tion, to  all  of  his  friends,  of  their  belief  To  show  that  these 
are  not  idle  statements,  it  is  only  necessary  to  state  that  on 
August  26,  1892,  a  negro  minister,  named  Moulton,  was 
hanged  in  Camden,  New  Jersey,  for  the  murder  of  an  aged 
colored  woman,  who  was  boarding  with  him.  In  accordance 
with  this  commonly-accepted  belief  of  killing  persons  for  use 
on  the  dissecting-table,  he  had  offered  her  body,  before  her 
murder,  to  a  medical  student  at  the  University  of  Pennsylvania. 
When  asked  by  the  student  how  he  could  supply  a  living  per- 

1  The  history  of  this  outgrowth  of  medical  work,  which  is  intensely  interesting,  can 
be  found  in  the  London  Lancet ;  the  Life  of  Sir  Astley  Cooper  ;  the  Life  of  Robert  Knox,  the 
Anatomist ;  The  London  Medical  Times  and  Gazette,  etc.  Dickens  also,  in  his  novel  of 
Our  Mutual  Friend,  presents  a  sketch  of  the  life  of  a  resurrectionist. 


DR.    AGNEW    IN    THE    SCHOOL    OF    ANATOMY.  91 

son  for  this  purpose,  he  rephcd,  noiiclialantly,  tluat  he  would 
"  put  lior  out  of  tlie  way."  The  circumstances  of  tlie  case  were 
reported  to  the  pohce,  but  tliey  beheved  the  whoh;  affair  to  be  a 
joke,  and  so  took  no  action  in  the  matter  until  the  unfortunate 
old  woman  lost  her  life. 

The  Scliool  of  Anatomy  continued  to  prosper  for  nearly 
eight  years,  until  the  mutterings  of  the  Civil  War  were  first 
heard,  when  the  old  school  was  the  scene  of  one  of  the  earliest 
breaks  in  our  national  life.  For  a  few  short  months  its  career 
was  crippled,  and  it  lost  its  principal  source  of  revenue, — its 
Southern  students.  A  very  large  proportion  of  the  medical 
students  of  that  day,  as  well  as  of  this,  wlio  were  attracted  to 
Philadelphia,  came  from  the  South  and  Southwest.  In  the 
winter  of  1859-60,  so  much  excitement  was  created  in  Phila- 
delphia by  John  Brown's  invasion  of  Virginia,  and  so  much 
sympathy  was  shown  for  him  and  his  adherents,  that  the  spirit 
and  enthusiasm  of  the  Southern  students  were  thoroughly 
aroused,  and  they  determined  to  leave  Philadelphia  and  seek 
more  congenial  localities  for  study.  A  telegram  from  Governor 
Wise,  of  Virginia,  requesting  them  to  leave  Pliiladelphia,  pre- 
cipitated this  action.  In  consequence,  by  the  middle  of  Feb- 
ruary, 1860,  most  of  the  Southern  students  left  Philadelphia 
in  a  body,  to  go  to  the  medical  schools  in  Baltimore  and  Rich- 
mond. This  occurred  before  the  people  of  the  North  were  fully 
aroused  to  the  fact  tliat  a  struggle  was  approaching.  It  was 
feared,  at  this  time,  that  the  school  would  suffer  severely  from 
this  defection  of  the  larger  portion  of  its  students;  but  many 
new  students  from  the  South,  despite  the  uncertain  condition  of 
the  country,  came  in  the  fall  of  1860.  When,  however,  war 
was  actually  declared,  the  school  lost  all  its  Southern  patronage. 

Dr.  Agnew's  records  of  his  students,  at  this  time,  show  only 
an  occasional  pupil  from  neighboring  Southern  States.  For- 
tunately, however,  the  school  was  not  injured  at  all,  financially, 
for,  of  course,  the  fees  of  the  term  during  which  the  defection 
took  place  were  already  paid,  and,  as  compensation  for  the  loss 


92  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

of  these  students,  the  demands  of  the  war  sent,  in  their  places, 
students  preparing  for  field  service  ;  so  that  the  classes  continued 
about  the  same  in  number. 

The  receipts  from  the  School  of  Anatomy,  when  it  was  in 
successful  operation,  were  sufficient  to  repay  a  physician  moder- 
ately for  his  work.  The  uniform  fee  for  each  course  was  $10 
from  the  starting  of  the  scliool  to  the  present  day.  There  were 
two  courses  through  the  year ;  so  that  the  receipts  from  the 
school,  with  several  hundreds  of  students,  were  considerable. 
The  extent  to  which  the  school  could  attain  in  its  financial  re- 
turns is  shown  in  the  case  of  Dr.  McClintock  when  he  had  the 
school,  from  1838  to  1840.  His  receipts  from  his  winter  classes 
for  1838  to  1839  were  $190.  His  receipts  from  his  spring  course 
were  $40 ;  so  that  he  made  from  his  lecturing,  for  the  year, 
$230.  The  next  year,  the  winter  of  1839-40,  his  receipts  were 
$1155  for  his  winter  course  and  $50  for  his  spring  course. 

As  the  years  rolled  by  and  the  school  came  into  Dr. 
Agnew's  hands,  the  receipts  were  increased  many-fold.  It  is  an 
easy  calculation  to  see  what  his  income  was ;  but  any  estimate 
would  be  too  low,  from  the  fact  that  he  gave  two  courses  in  the 
year,  the  summer  session  attracting  from  twenty-five  to  fifty 
students  at  the  same  fees  as  paid  for  the  winter  work.  In 
addition,  the  fees  from  the  School  of  Operative  Surgery,  founded 
by  Dr.  Agnew,  also  greatly  increased  his  income.  As  has  been 
said,  his  classes  in  this  school  varied  from  thirty  to  fifty  in  each 
course,  which  was  comparatively  short.  At  the  same  time,  this 
was  far  below  the  pecuniary  returns  for  successful  work  in  other 
professions  or  occupations. 

Dr.  Agnew  paid  $600  for  this  school,  which,  consider- 
ing the  fact  that  he  had  but  nine  students  and  but  a  small 
number  of  specimens  for  demonstration,  was  a  considerable 
sum.  He  sold  the  school  to  Dr.  Garretson  for  the  same 
amount, — a  characteristic  stroke  of  business, — although  his 
students  had  increased  from  nine  to  two  hundred  and  sixty- 
seven,   making,  probably,  the  largest   private  class,  under  an 


DR.    AGNEW    IN    THE    SCHOOL    OF    ANATOMY.  93 

individual,  independent  medical  teacher,  in  the  history  of  tlie 
world. 

In  1862  Dr.  Agnew  relinquished  the  anatomical  depart- 
ment of  the  school  to  Dr.  James  E.  Garretson,  who  had  been 
his  demonstrator  for  several  years.  Dr.  Agnew  retained  the 
course  in  operative  surgery  for  a  year  longer,  until  he  was  made 
Demonstrator  of  Anatomy  and  Lecturer  on  Clinical  Surgery  at 
the  University  of  Pennsylvania.  He  was  succeeded  in  the  De- 
partment of  Operative  Surgery,  from  1864  to  1867,  by  Dr.  J.  M. 
Boisnot.  After  two  years  of  successful  teaching  Dr.  Garretson 
withdrew-  from  the  anatomical  department,  on  his  election  to 
the  Chair  of  Surgery  in  the  Philadelphia  Dental  College.  In 
accordance  with  the  influence  of  the  school,  Dr.  Garretson  was 
not  idle  with  his  pen,  for  he  has  since  published  his  large  work 
on  "  Oral  Surgery  "  and  a  number  of  charming  pliilosophical 
and  metaphysical  reflections,  under  the  pen-name  of  "John 
Darby." 

In  the  summer  of  1865  Dr.  James  P.  Andrews  assumed 
the  duties  of  Lecturer  on  i\natomy,  but,  his  health  failing,  he 
was  succeeded,  in  the  fall,  by  Dr.  li.  S.  Sutton.  After  teacliing 
for  a  year.  Dr.  Sutton  was  succeeded  by  Dr.  W.  W.  Keen,  who 
conducted  the  school  successfully  until  1875. 

From  1866  to  1870  Dr.  Keen  occupied  only  the  western 
building,  Dr.  D.  D.  Richardson  having  the  lower  story  of  the 
other  for  his  quiz  class,  and  Dr.  H.  Lenox  Hodge,  from  1866  to 
1870,  the  upper  story  for  his  courses  on  operative  surgery;  but, 
in  order  to  accommodate  his  increasing  class.  Dr.  Keen  was 
obliged,  in  1870,  to  obtain  the  use  of  that  building,  and,  later 
still,  enlarged  the  lecture-room  by  placing  a  gallery  over  his  head. 
While  connected  with  the  school.  Dr.  Keen  published  many 
articles,  besides  gathering  the  materials  for  more  extended  sub- 
sequent publications. 

In  1873  the  University  of  Pennsylvania  had  been  removed 
to  West  Philadelphia.  Previously  tlie  school  had  drawn  its 
pupils  from  both  the  University  and  Jefferson  Medical  College. 


94  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

It  was  clear  to  Dr.  Keen  that  he  must  become  ah  appendage 
to  one  school  or  the  other,  for,  if  he  attempted  to  build  at  a 
point  between  the  two  schools,  he  would  not  receive  sufficient 
support  to  make  his  venture  a  success.  Moreover,  at  the  same 
time,  the  government  took  the  ground  on  which  the  principal 
building  stood  as  a  portion  of  the  site  for  the  new  post-office, 
and  so  prevented  the  possibility  of  the  school  remaining  where 
it  was.  Dr.  Keen  went  so  far  as  to  purchase  two  properties  on 
Sansom  Street  above  Sixteenth  as  a  site  for  a  new  school,  but, 
after  consultation  with  friends,  he  decided  not  to  build.  There- 
fore, on  March  1,  1875,  Dr.  Keen  delivered  the  final  lecture  in 
the  old  Chant  Street  building.  This  lecture  was  appropriately 
devoted  to  a  carefully-verified  history  of  the  old  school  and  its 
honored  teachers. 

Dr.  Keen's  death-song  proved  to  be,  however,  only  a 
lullaby.  The  vitality  of  the  old  name  was  greater  than  had 
been  expected,  for  Dr.  J.  M.  Boisnot,  one  of  the  old  teachers 
of  the  school,  opened  another  institution  under  this  name  at 
1022-24  Hunter  Street,  a  short  distance  from  the  old  location, 
the  year  after  the  closing  of  the  school  by  Dr.  Keen.  As  the 
school  was  not  continued  in  its  original  location  and  the  good- 
will and  fixtures  not  purchased,  as  had  been  the  custom  through 
all  the  various  vicissitudes  of  its  existence,  it  is  a  matter  of  dis- 
pute as  to  what  degree  of  relationship  should  be  conceded  as 
existing.  On  the  other  hand,  it  can  be  claimed  by  the  later 
teachers  that,  as  the  site  of  the  old  school  was  gone,  its  scholars 
and  teaching-material  scattered,  there  were  no  fixtures  and 
good-will  to  be  purchased.  Moreover,  the  new  school  was 
started  by  a  former  teacher  in  the  original  school. 

Undoubtedly,  however,  this  was  the  most  serious  break  in 
the  history  of  the  school.  Dr.  Boisnot  associated  with  him,  in 
the  latter  part  of  his  career,  Dr.  J.  M.  Barton,  who  lectured  on 
operative  surgery.  Dr.  John  B.  Roberts  obtained  possession  of 
the  school  in  1878,  Dr.  Barton  continuing  his  lectures.  The 
new  school  grew,  until  it  retained  a  number  of  lecturers :  Dr. 


DR.    AGNEW    IN    THE    SCHOOL    OF    ANATOMY.  95 

H.  Augustus  Wilson,  on  orthopedic  surgery ;  Henry  LefFman, 
on  chemistry ;  J.  T.  Eskridge,  on  physical  diagnosis ;  Wm.  H. 
Parish,  on  obstetrics  and  gynecology;  C.  W.  Dulles,  on  venereal 
diseases;  E.  H.  Bell,  on  obstetrics  and  gynecology;  and  C.  E. 
Sajous,  on  the  throat  and  nose. 

It  was  from  this  nucleus  that  the  Philadelphia  Polyclinic 
and  College  for  Graduates  in  Medicine  started,  in  1882-83,  at 
Thirteenth  and  Locust  Streets.  After  the  withdrawal  of  the 
staff  of  lecturers  for  this  purpose,  the  school  again  contracted  to 
its  original  work  of  teaching  anatomy,  while  its  brilliant  off- 
spring started  on  its  broader  career.  The  inroads  of  business 
finally  drove  the  school  from  Hunter  Street  to  Cuthbert  Street 
above  Eleventh  in  1883,  when  Dr.  L.  W.  Steinbach  became 
owner  of  the  school.  It  wandered  from  here  to  the  northwest 
corner  of  Tenth  and  Arch  Streets  in  1883.  In  188-1  the  school 
passed  into  the  hands  of  Dr.  Henry  C.  Boenning,  who  holds  it 
at  the  present  time  (1892).  In  1887  the  school  again  moved, 
this  time  to  the  building  of  the  Third  National  Bank,  at  Broad 
and  Market  Streets,  opposite  the  Pennsylvania  Bailroad  Depot. 

It  is  still  in  a  flourishing  location,  being  now  situated  in 
the  building  of  the  Medico-Chirurgical  College,  on  Cherry 
Street  below  Eighteenth,  where  it  exists  in  connection  with  that 
school  and  the  Philadelphia  Dental  College ;  it  is,  however, 
still  an  independent  school,  paying  its  own  way,  and  holding 
the  privilege  of  accepting  or  rejecting  the  students  who  present 
themselves.  It  draws  its  pupils  still  from  the  Medico-Chirur- 
gical College,  the  Philadelphia  Dental  College,  the  University 
of  Pennsylvania,  Jefferson,  the  Women's  Medical  College,  and 
those  art  students  from  the  Academy  of  Fine  Arts  who  wish  to 
study  human  anatomy. 

While  the  Philadelphia  School  of  Anatomy  was  in  no 
sense  a  "  quiz  class,"  remaining  always  an  independent  factor 
in  medical  teaching,  yet  at  the  same  time  it  gathered  in  its 
train,  naturally,  the  elements  which  subsequently  developed  into 
quiz  work.     The  quiz  is  a  coaching  class  in  which  the  knowl- 


96  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

edge  of  the  medical  student  is  reviewed,  systematized,  and 
stamped  upon  his  mind.  It  is  generally  the  ivy  clinging  to  the 
oak, — the  ground  covered  being  regulated  by  the  lectures  of  the 
professor  who  is  in  charge  of  the  subject  in  the  medical  school. 
A  large  part  of  the  brilliant  reputation  of  the  School  of  Anatomy 
is  due  to  the  men  who  used  its  accommodations  for  this  work. 

The  first  one,  as  far  as  can  be  determined,  who  established 
a  quiz,  thereby  enlarging  the  facilities  of  his  office  students,  was 
Dr.  Nathaniel  Chapman.  In  1817  he  associated  with  himself 
Dr.  Horner,  on  anatomy,  and  they  occupied  a  room  over  his 
stable — a  rather  favorite  place,  it  would  seem,  for  anatomists — 
in  the  rear  of  his  house,  on  the  south  side  of  Walnut  Street,  the 
second  door  below  Eighth.  In  1819-20  Dr.  Dewees  joined 
them,  and,  soon  after,  Drs.  Hodge,  Bell,  Jackson,  J.  K.  Mitchell, 
and,  for  some  time.  Dr.  T.  P.  Harris.  This  afterward  became 
the  "Medical  Institute,"  obtained  a  charter,  and  erected  a 
building  in  Locust  Street  above  Eleventh,  afterward  occupied, 
from  1846  to  1818,  by  the  "Frankhn  Medical  College."  This 
quiz  organization  is  still  in  existence  at  the  University  of 
Pennsylvania. 

In  1818  Dr.  Joseph  Parrish  began  a  similar  association 
with  Dr.  George  B.  Wood,  and  afterward  also  Drs.  Richard 
Harlan  and  Shoemaker.  From  this,  in  1830, arose  the  "Phila- 
delphia Association  for  Medical  Instruction,"  consisting  of  Drs. 
Parrish,  Wood,  Samuel  George  Morton,  John  Phea  Barton,  and 
Franklin  Bache,  who  were  joined  at  various  times  by  Jacob 
Pandolph,  W.  W.  Gerhard,  Joseph  Pancoast,  and  William 
Push.  For  six  years  the  association  continued  its  labors ;  but 
then,  as  some  grew  in  years  and  practice,  and  others  were  ab- 
sorbed by  the  colleges,  it  was  dissolved.  The  "  School  of  Med- 
icine" was  a  third  similar  organization  formed  about  the  same 
time,  in  which  were  Drs.  William  Gibson,  Jacob  Pandolph,  B. 
H.  Coates,  Pene  La  Poclie,  John  Hopkinson,  and  Charles  D. 
Meigs.  Nearly  all  of  these  became  professors  in  the  University 
of  Pennsylvania  or  the  Jefferson  Medical  College. 


DR.    AGNEW    IN    THE    SCHOOL   OF    ANATOMY.  97 

In  1842,  while  Dr.  Jonathan  M.  Allen  was  at  the  head  of 
the  Philadelphia  School  of  Anatomy,  the  second  "  Philadelphia 
Association  for  Medical  Instruction,"  generally  known  as  the 
"  Summer  Association,"  was  formed  for  the  purpose  of  giving 
lectures  during  the  long  recess  in  the  colleges  from  March  to 
November.  It  consisted,  originally,  of  Drs.  John  F.  Meigs,  on 
obstetrics;  Joshua  M.  Wallace,  on  surgery;  Robert  Bridges, 
on  chemistry ;  Francis  Gurney  Smith,  on  physiology ;  and 
Jonathan  M.  Allen,  on  anatomy.  The  lectures  were  given  in 
the  eastern  building  till  about  1847,  when  they  changed  to  the 
western  one,  and  in  1854  to  Butler's  Avenue,  in  the  rear  of 
the  Jefferson  Medical  College.  Here  they  continued  till  1860, 
when  they  disbanded. 

In  1845  Dr.  J.  F.  Meigs  began  to  lecture  at  the  School  of 
Anatomy  on  diseases  of  children,  Dr.  D.  H.  Tucker  on  obstetrics, 
and  in  1850,  on  his  removal  to  the  Richmond  Medical  College 
as  Professor  of  Obstetrics,  he  was  followed  by  Dr.  William  Y. 
Keating.  At  Dr.  J.  M.  Wallace's  death  the  surgical  lecture- 
ship was  filled  by  the  appointment  of  Dr.  J.  H.  B.  McClellan  in 
1851,  Dr.  Addinell  Hewson  in  1853,  and  Dr.  John  H.  Brinton 
in  1860.  Dr.  Bridges,  although  elected  to  the  College  of  Phar- 
macy, retained  his  lectureship  on  chemistry  from  1842  to  1860, 
— the  only  constituent  member  of  the  association  who  remained 
to  its  close.  In  anatomy,  when  Dr.  Allen  became  Professor  of 
Anatomy  in  the  Pennsylvania  College,  in  1852,  Dr.  Ellerslie 
Wallace,  then  also  Demonstrator  of  Anatomy,  and  later  Pro- 
fessor of  Obstetrics  at  Jefferson,  became  his  successor. 

Dr.  Francis  Gumey  Smith  continued  to  lecture  on  physiol- 
ogy till  1852,  w^hen  he  was  elected  to  the  professorship  of  physi- 
ology in  the  Pennsylvania  College,  and  was  succeeded  by  Dr. 
S.  Weir  Mitchell  until  1860.  The  first  lecturer  on  practice  was 
Dr.  Alfred  Stille,  who  joined  the  association  in  1844  and  resigned 
in  1850  on  account  of  ill  liealth.  In  1854  he  became  Professor 
of  Practice  in  Pennsvlvania  Colleo-e,  and  later  filled  the  same 
chair  in   the  Universitv.     He  was  succeeded  bv  Dr.  John  F. 


98  LIFE    OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

Meigs  from  1850  to  185-i,  and  he  again,  in  1855,  by  Dn 
Moreton  Stille,  the  brother  of  Alfred  Stille,  and  akeady 
widely  known  as  the  joint  author  of  "  Wharton  and  Stille's 
Medical  Jurisprudence."  A  career  of  great  prominence  was 
then  suddenly  cut  short  by  a  sad  accident.  A  decomposing 
subject  left  in  the  lecture-room  from  Friday  until  Monday,  in 
July,  so  poisoned  the  air  that  Stille  and  several  of  the  class  were 
made  faint  and  sick.  Stille  still  lectured  as  long  as  he  could, 
but  finally  was  compelled  to  yield,  went  home,  and,  after  a 
brief  illness,  died  from  blood-poisoning.  The  next  year  the 
place  was  filled  by  Dr.  J.  M.  Da  Costa,  subsequently  Professor 
of  Practice  at  Jefferson  Medical  College.  Dr.  Francis  West 
lectured  on  materia  medica  from  1844  till  the  last  year,  when 
Dr.  James  Parrish  succeeded  him.  On  diseases  of  children 
Dr.  John  F.  Meigs  was  the  only  lecturer  from  1840  to  1850, 
and  on  medical  jurisprudence  Dr.  Edward  Hartshorne  from 
1847  to  1849. 

Dr.  Da  Costa  also  gave  private  courses  on  physical  diag- 
nosis from  1854  to  1863.  Such  was  his  reputation  at  this  time, 
especially  a  year  before  their  close,  that  he  was  compelled  to  refuse 
many  anxious  applicants,  lest  the  classes  should  become  un- 
wieldy for  his  methods  of  personal  instruction. 

The  front  room  on  the  lower  floor,  and  afterward  that  in 
the  second  story,  was  occupied  by  Dr.  S.  Weir  Mitchell  as  his 
physiological  laboratory.  Besides  his  lectures  on  physiology  in 
the  association,  from  1853  to  1860,  he  gave,  in  1856,  the  first 
purely  experimental  course  on  physiology  in  the  city,  and  also 
made  in  these  rooms  nearly  all  of  his  extremely  important  phys- 
iological experiments  and  discoveries,  working  with  dogs,  cats,  and 
copperhead,  moccasin,  and  rattle  snakes.  Many  are  the  amusing 
stories  that  could  be  told  of  this  somewhat  perilous  work  with 
snakes ;  of  the  rude  and  insecure  boxes  in  which  they  were  re- 
ceived, sometimes  a  section  from  the  hollow  trunk  of  a  tree  bat- 
tened at  each  end  with  scanty  nails;  of  the  suddenly-discovered 
escape  of  a  snake  or  two  on  more  than  one  occasion, — a  dis- 


DR.    AGNEW    IN    THE    SCHOOL    OF    ANATOMY.  99 

covery  none  the  less  disquieting  from  the  ilict  that  no  antidote  had 
as  yet  been  found  among  the  scientific  harvest ;  or  of  the  janitor 
who,  one  night,  when  locking  up,  being  slightly  mystified  by 
sundry  potations,  and  treading  on  a  headless  snake,  that  rattled 
vigorously  and  struck  him  with  its  stump,  ran  to  a  brick-pile 
near  by,  and,  filling  his  arms  with  the  bricks,  let  fly  at  random 
into  the  dark  room, — he  had  more  tlian  St.  Patrick's  aversion  to 
snakes, — and  bottles,  crucibles,  costly  thermometers,  and  two 
weeks  of  carefully  prepared  results  were  in  the  morrow's  woeful 
count  of  cost.  Many  were  the  assistants  who  came,  and,  not 
liking  the  work,  quietly  disappeared;  one  of  them,  however, 
rather  hurriedly,  for  he  sat  down  all  unconscious  upon  a  lighted 
cigar,  and,  leaning  rudely  against  the  snake-box,  started  them  to 
rattling  just  as  the  cigar  burned  through,  when,  leaping  up  in 
affright,  he  ran  away,  crying  "  I'm  bitten !  I'm  bitten ! "  and 
was  seen  no  more. 

It  can  now  be  easily  understood  how  not  so  much  even  as 
a  chip  had  ever  been  stolen  with  such  objects  in  the  building, 
both  dead  and  alive,  although  the  door  often  went  unlocked  and 
the  cellar  was  almost  always  accessible.  Even  a  former  office-boy 
of  Dr.  Keen,  of  African  extraction,  could  never  be  induced  to 
put  foot  inside  the  building,  alleging  that  he  had  "  heerd  of 
their  layin'  for  colored  boys  afore  now ! " 

It  is  interesting  to  note  that  the  only  thing  reported  to  have 
been  stolen  during  the  regime  of  Dr.  Agnew  was  a  valuable 
paper  which  he  had  intrusted  to  an  assistant,  and  which  the 
latter  had  stuffed  in  the  pocket  of  his  overcoat,  leaving  it  in  the 
museum  as  he  stepped  into  the  lecture-hall  of  the  school.  On 
returning  from  his  lecture,  the  demonstrator  found  that  some- 
body had  stolen  the  coat.  He  was  naturally  much  more  con- 
cerned over  the  loss  of  the  paper  than  over  the  article  of  cloth- 
ing, and  spent  a  restless  night  thinking  of  his  loss.  Curiously 
enough,  however,  the  thief  had  the  interest  of  the  school  suf- 
ficiently at  heart  to  return  the  abstracted  paper  by  the  next 
morning's  mail. 


100  LITE   OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

No  more  brilliant  corps  of  teachers,  perhaps,  has  ever  been 
gathered  in  this  city  than  this  old  "Summer  Association." 
Tucker  became  Professor  of  Obstetrics  first  in  Franklin  College, 
and  then  in  Richmond ;  Keating  went  to  the  Jefferson ;  Bridges 
to  the  Frankhn  College  and  the  College  of  Pharmacy ;  Allen,  as 
Professor  of  Anatomy,  to  the  Pennsylvania  College ;  EUerslie 
Wallace,  first  as  Demonstrator  of  Anatomy,  and  then  Professor 
of  Obstetrics,  to  the  Jefferson ;  Francis  Gurney  Smith  to  the 
Cliair  of  Physiology  in  the  Pennsylvania  College,  and  then  in  the 
University  of  Pennsylvania;  Alfred  Stille  to  that  of  Practice  in 
Pennsylvania  College,  and  then  to  the  University ;  Da  Costa  to 
the  Cliair  of  Practice  in  the  Jefferson  ;  Mitchell  here  formed  that 
habit  of  exact  scientific  observation  and  sagacious  deduction 
which  has  given  him  a  reputation  on  two  continents,  while 
Meigs,  McClellan,  Hewson,  Brinton,  Darrach,  and  Hartshorns 
have  all  become  well-known  hospital  teachers  and  practitioners. 

As  writers,  during  this  period,  few  men  have  been  busier. 
Among  the  medical  books  and  papers  which  were  the  direct 
results  of  their  labors  here,  the  following  may  be  mentioned : 
Dr.  Tucker  wrote  his  "  Principles  and  Practice  of  Midwifery." 
Dr.  Alfred  Stille  pubUshed  a  part  of  his  lectures  under  the  title 
of  "Elements  of  General  Pathology,"  while  the  lectures  on 
"Practice,"  most  carefully  and  "elaborately  written  out,  have 
formed  the  foundation  of  all  those  upon  the  same  subject  which 
he  has  since  delivered."  He  also  published  his  "Medical  Insti- 
tutions of  the  United  States"  and  his  "  Report  on  Medical  Liter- 
ature," and  with  Dr.  Meigs  translated  Andral's  "  Pathological 
Hematology."  Dr.  John  F.  Meigs  published  his  lectures  on  the 
"  Diseases  of  Children,"  the  well-thumbed  book  of  multitudes  of 
practitioners,  now  grown  to  be  a  most  portly  volume.  Dr.  F. 
G.  Smith  translated  Barth  &  Roget's  "  Manual  of  Auscultation 
and  Percussion,"  and  edited  Carpenter's  various  physiological 
works,  "Kirkes'  Paget's  Physiology,"  and  "Churchill  on  Ob- 
stetrics." Dr.  Keating  edited  "  Ramsbotham's  Obstetrics " 
and  "Churchill  on   Children."     Dr.  Bridges  edited  "  Fowne's 


DR.    AGNEW    IN    THE    SCHOOL    OF    ANATOMY.  101 

Chemistry  "  and  "  Graliam's  Chemistry."  Dr.  Hewson  edited 
"  Mackenzie  on  the  Eye  "  and  "  Wilde  on  the  Ear,"  and  all  of 
them  wrote  numerous  papers,  reviews,  etc.,  and  practised  medi- 
cine into  the  bargain !     Truly,  they  were  busy  men. 

In  1855,  during  Dr.  Agnew's  administration,  another  asso- 
ciation was  started,  which,  like  the  one  just  named,  was  called 
after  an  older  one,  already  noticed,  the  "  Pennsylvania  Academy 
of  Medicine."  It  consisted  of  Drs.  W.  W.  Gerhard,  Henry  H. 
Smith,  D.  Hayes  Agnew,  Bernard  Henry,  E,.  A.  F.  Penrose,  and 
Mr.  Edward  Parrish,  the  son  of  Dr.  Joseph  Parrish,  who  lec- 
tured on  practical  pharmacy ;  the  next  year  they  were  joined 
also  by  Dr.  Edward  Shippen.  For  two  years  they  continued  as 
an  association  of  lecturers ;  then  Drs.  Gerhard,  Agnew,  Penrose 
and  Mr.  Parrish  went  on  as  a  quiz  association  for  a  year,  when 
they  disbanded.  Dr.  Agnew  went  on  with  his  usual  courses  in 
the  School  of  Anatomy,  and  Dr.  Penrose  continued  to  lecture 
here  on  obstetrics  until  called  to  the  University,  in  1863.  They 
were  equally  fortunate  in  promotion  with  the  members  of  the 
other  association,  for  four  of  the  seven  went  to  the  University  as 
professors, — Gerhard  on  clinical  medicine,  Henry  H.  Smith 
and  Agnew  as  professors  of  surgery,  and  Penrose  of  obstetrics. 

Besides  these  distinct  associations  for  lecturing,  numerous 
other  independent  experimenters  have  availed  themselves  of  the 
facilities  afforded  by  the  School  of  Anatomy  for  their  work. 

In  1849  Dr.  Brown-Sequard  gave  his  first  lecture  in 
America  in  this  school,  to  Dr.  Francis  Gurney  Smith's  class  in 
physiology,  in  the  "  Summer  Association."  It  was  on  the  physi- 
ology of  the  nervous  system ;  and  during  the  lecture,  with  that 
extraordinary  manual  dexterity  for  which  he  is  noted,  he  cut 
the  anterior  and  posterior  roots  of  the  spinal  nerves  in  some 
frogs,  and  demonstrated  the  cross-sensibility  of  the  spinal  mar- 
row by  sections  of  its  lateral  halves  in  the  guinea-pig.  This 
was  followed  by  a  course  to  the  physicians  of  the  city.  His 
next  course  was  given  in  the  Franklin  Institute.  About  this 
time,  also,  Dr.  John  Hastings,  of  the  nav}%  gave  some  lectures 


102  LIFE   OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

on  yellow  fever, — apropos  of  the  then  existing  epidemic, — 
based  on  his  personal  observations  during  the  Mexican  War. 
In  1859  Dr.  Samuel  W.  Gross,  while  one  of  Dr.  Agnew's 
demonstrators,  gave  courses  on  operative  surgery  and  surgical 
anatomy,  and  again  in  1866-67.  In  1860,  and  foT  some 
time  afterward,  Dr.  John  W.  Lodge  gave  courses  in  experi- 
mental physiology  in  the  summer,  and  on  urinary  pathology 
in  the  winter.  In  obstetrics.  Dr.  J.  M.  Corse  also  lectured 
here.  In  1864  to  1867  Dr.  J.  M.  Boisnot,  and  also,  in  1865 
to  1867,  Dr.  J.  Bernard  Brinton,  each  gave  courses  in  operative 
surgery. 

When  Dr.  Keen  had  charge  of  the  school,  Dr.  Isaac  Ott 
experimented  on  cocaine  and  other  poisons,  and  Dr.  H.  C.  Wood 
on  the  physiological  action  of  the  alkaloids  of  veratrum  viride. 
Besides  these,  the  following  regular  courses  of  lectures  have 
been  given  here :  On  obstetrics,  Drs.  F.  H.  Getchell  and  W.  F. 
Jenks ;  on  the  microscope,  Dr.  James  Tyson ;  Dr.  Hodge  gave 
independent  courses  on  operative  surgery  from  1868  to  1870 
in  the  eastern  building ;  Drs.  J.  Ewing  Mears  and  O.  H.  Allis 
on  bandaging  and  fractures ;  Drs.  John  S.  Parry,  O.  P.  Rex, 
Stanley  Smith,  and  Hamilton  Osgood,  on  physical  diagnosis ; 
on  venereal  diseases.  Dr.  William  G.  Porter;  on  ophthalmol- 
ogy, Drs.  George  C.  Harlan,  George  Strawbridge,  and  W.  W. 
McClure ;  and  on  laryngoscopy,  Dr.  J.  Solis  Cohen.  For  a 
number  of  years,  also,  the  Naval  Examining  Board  examined 
all  their  candidates  for  admission  and  promotion  here.  In  1837 
Dr.  E.  G.  Davis  quizzed  on  all  the  branches  himself,  as  also,  at 
first,  was  Dr.  D.  D.  Richardson's  habit.  Dr.  Richardson's  quiz 
lasted  from  1860  to  1871,  and  in  the  last  few  years  he  was  as- 
sisted by  Drs.  Boisnot,  Cohen,  and  Witmer.  From  1866  to  1868 
Dr.  Keen  quizzed  with  Drs.  Duer,  Dunglison,  and  Maury;  in 
1868-69  with  Drs.  Warder,  McArthur,  Leaman,  and  Mears; 
and  from  1869  to  1872  with  Drs.  Hutchins,  Allis,  Rex, 
Getchell,  Leffman,  and  Loughlin.  In  1874-75  Drs.  Wilson, 
West,  Greene,  and  Osgood  gave  quiz  courses.     From  1869  to 


DR.    AGNEW    IN    THE    SCHOOL    OF    ANATOMY.  103 

1871,  also,  the  eastern  building  was  occupied  by  the  quizzes  of 
Drs.  Willard,  Curtin,  Cheston,  Jenks,  Wilson,  and  Gitliens. 

Sucli,  in  brief,  is  the  history  of  this  venerable  school,  and 
of  the  many  teachers  associated  with  it.  Over  one  hundred 
teachers  won  their  spurs  in  its  lecture-rooms,  formed  here  their 
habits  of  thought,  style  of  lecturing,  methods  of  scientific  re- 
search, and  gained  their  early  fame  as  writers  and  teachers,  so 
that  thirty-two  have  become  professors  in  sixteen  medical  col- 
leges, here  and  elsewhere,  and  seventy  hospital  and  clinical 
physicians,  surgeons,  obstetricians,  etc.,  of  distinction.  Thirty- 
two  books  have  been  written  or  edited,  and  many  pamphlets  and 
papers  of  value  have  been  published  by  its  various  teachers. 

Its  assistant  demonstrators  are  too  numerous  even  for  men- 
tion. The  students  of  this  old  school  can  never  be  traced,  but 
this  much  is  known,  that,  spread  all  over  the  world,  doing  faith- 
fully their  daily  work  in  relieving  the  suffering,  soothing  the 
dying,  helping  the  poor,  assuaging  the  pestilence  that  walketh 
in  darkness,  improving  the  public  health,  advancing  the  domain 
of  pure  and  applied  science,  teaching  earnestly  its  results  to 
thousands  of  eager  students  who,  in  turn,  will  swell  their  noble 
ranks,  promoting  in  general  the  moral  and  material  welfare  of 
mankind,  some  in  lofty,  some  in  lowly  station,  they  will  confess 
that  here  they  first  developed  their  scientific  tastes  and  aspira- 
tions ;  here  they  were  taught  to  look  beyond  the  lower  to  the 
highest  and  noblest  aims  of  their  profession ;  here  they  first 
caught  the  inspiration  that  has  made  them  what  they  are,  and 
here  they  learned  to  love  this  old  school  and  its  faithful  teachers. 

So  great  had  grown  the  reputation  of  Dr.  Agnew  in  later 
years,  and  his  connection  with  the  School  of  Anatomy  was  so 
quoted  in  all  accounts  of  his  life,  that  the  public  at  large  and 
the  younger  members  of  the  medical  profession  are  inclined  to 
suppose  that  he  was  its  originator,  and  that  he  constituted  its 
only  glory.  On  the  contrary,  this  brief  history  shows  the  close 
connection  between  the  old  school  and  a  large  proportion 
of  the  medical  profession  of  Philadelphia.     The  majority  of  the 


104  LIFE    OF    D.    HATES    AGNEW,    M.D,,    LL.D. 

names  mentioned  in  this  brief  resume  are  famous  ones  in  Phila- 
delphia to-day.  Dr.  Agnew  practically  built  a  new  school  here, 
but  it  was  made  on  the  ruins  of  an  older  structure.  He  did 
found,  however,  the  School  of  Operative  Surgery,  which  put 
into  practical  use  the  knowledge  gained  in  the  School  of 
Anatomy. 

So  great  was  the  concentration  of  mind  of  Dr.  Agnew  in  his 
earlier  years  upon  his  work  that  those  who  were  his  assistants  for 
many  years,  and  intimately  associated  with  him  in  his  daily  work 
at  the  School  of  Anatomy,  were  unable  to  refer  subsequently  to 
any  special  conversation  held  during  those  years  which  was  not 
related  in  some  way  with  anatomy  or  surgery.  To  Dr.  Gar- 
retson,  who  was  his  demonstrator  for  several  years.  Dr.  Agnew,  at 
this  period,  possessed  the  most  unspeculative  mind  on  the  subject 
of  religion  of  any  man  he  had  ever  met.  Distinctions  often 
propounded  by  Dr.  Garretson  regarding  human  hypostoses  of 
body,  ego,  and  soul,  as  the  dissectors  worked  together  over  a 
cadaver,  failed  always  to  elicit  from  the  elder  any  other  response 
than  that  he  was  sure  of  the  body  and  was  willing  to  leave  ego 
to  philosophy  and  soul  to  church, — a  most  characteristic  reply. 

In  the  later  years  of  his  connection  with  the  School  of 
Anatomy,  Dr.  Agnew  did  not  feel,  however,  the  necessity  for 
that  terrible  expenditure  of  force  and  energy  which  had  so 
characterized  his  earlier  work.  His  practice  was  growing ;  he 
was  being  called  more  and  more  into  consultation  ;  his  hospital 
opportunities  were  increasing ;  consequently,  he  devolved  the 
manual  work  more  and  more  upon  his  demonstrators. 

Undoubtedly,  much  of  the  grace,  ease,  and  sureness  with 
which  Dr.  Agnew  operated  was  due  to  his  perfect  knowledge 
of  anatomy  which  he  learned  in  this  school.  He  never  had  to 
stop  to  think  out  the  answers  to  questions  in  regional  anatomy. 
He  reached  his  conclusions  as  quickly  and  as  naturally  as  if  he 
were  reading  an  open  book,  which  justified  the  statement  that  he 
seemed  to  see  the  positions  and  relations  of  the  internal  organs 
of  the  body  as  well  as  if  their  coverings  were  made  of  glass. 


DR.    AGNEW    IN    THE    SCHOOL    OF    ANATOMY.  105 

He  acquired  also  a  most  beautiful  and  attractive  style  of 
lecturing,  which  drew  students  because  of  its  naturalness.  He 
learned,  as  has  been  truthfully  said,  to  present  Nature's  truths  in 
Nature's  simplicity,  without  the  deadly  paralysis  of  unnecessary 
words.  He  learned  to  go  at  once  to  the  gist  of  the  matter,  and, 
having  seized  upon  the  central  point  of  demonstration,  he 
grouped  all  the  secondary  features  in  beautiful  sequence  about 
it.  His  demonstrations  of  the  surgical  anatomy  of  hernia  or  the 
regional  anatomy  of  the  perineum  will  always  be  remembered 
by  those  who  were  fortunate  enough  to  have  been  his  students, 
as  most  clear,  concise,  and  yet  comprehensive. 

Dr.  Agnew,  when  he  relinquished  this  school,  had  been 
connected  longer  with  it  than  any  other  of  its  proprietors,  his 
whole  term  of  service,  including  his  connection  with  the  School 
of  Operative  Surgery,  being  eleven  years.  Although  he  had 
grown  famous  here,  and  had  been  by  far  its  most  successful 
teacher,  yet  he  was  only  the  second  to  leave  it  not  receiving  a 
professorship.  His  progress  forward  had  been  of  the  slowest 
nature.  He  would  not  push  himself,  and,  consequently,  his 
advance  was  not  rapid,  but  it  was  natural.  Other  men  were 
pushing  rapidly  by  him,  younger  and  less  well  known ;  but  Dr. 
Agnew 's  progress  was  satisfactory  to  himself.  He  was  receiving 
as  much  as  he  felt  he  deserved ;  and  his  reputation  was  not  a 
hot-house  plant,  ready  to  wither  at  the  first  chilly  touch,  but  a 
sturdy  out-door  growth,  which  the  colds  and  snows  of  winter 
could  not  affect. 

Dr.  Agnew's  final  separation  from  the  School  of  Anatomy 
occurred  in  December,  1863,  on  his  appointment  as  Demon- 
strator of  Anatomy  at  the  University  of  Pennsylvania. 


CHAPTER  V. 

Dr.  Agnew's  Early  Life  in  Philadelphia. 

Dr.  Agnew's  coming  to  Philadelphia  was  not  an  unusual 
thing  for  a  country  physician  to  do ;  for  probably  one-half,  at 
the  lowest  estimation,  of  the  successful  city  practitioners  of  to- 
day were  country  boys.  This  can  be  seen  by  taking  a  list  of 
the  prominent  physicians  of  Philadelphia,  New  York,  and 
Boston,  and  ascertaining  their  birth-places. 

To  the  credit  of  the  Philadelphia  physicians  of  that  day, 
it  must  be  said  that  Dr.  Agnew  was  received  with  considerable 
cordiality.  He  was  known,  already,  to  a  large  part  of  the  pro- 
fession in  the  city ;  among  the  residents  of  the  town  he  had 
some  relatives  and  many  friends.  He  was  not  treated  with  the 
coldness  and  neglect  experienced  by  Dr.  Sims  in  New  York, 
although  he  had  no  such  reputation  to  sustain  him  at  this  time 
as  had  that  gentleman.  On  the  other  hand,  he  did  not  come  to 
Philadelphia  like  Dr.  Gross,  with  the  appointment  to  a  promi- 
nent position  in  an  important  medical  school. 

He  had  his  name  to  make  and  his  fortune  to  acquire.  His 
experience  as  a  surgeon  had  been,  as  yet,  limited.  He  had 
done  a  number  of  major  surgical  operations,  performing  some 
of  them  as  early  as  1840;  but  he  had  fallen  behind  many  of  his 
classmates  in  this  work,  on  account  of  giving  up  his  professional 
duties  for  over  three  years. 

Possibly,  it  was  the  quiet,  unobtrusive,  but  determined, 
manner  in  which  he  began  his  new  career  that  caused  him  to 
be  well  treated  and  warmly  welcomed  by  his  fellow-practitioners 
in  Philadelphia.  In  his  early  years,  as  well  as  later,  his  career 
was  never  aggressive;  he  forced  no  one  from  his  place  or 
practice ;  while  his  hard  and  conscientious  work  won  for  him 
hosts  of  friends  and  confidence  in  his  abilities. 

As  years  rolled  by,  his  position  became  easier  and  pleas- 
(i06) 


DR.    AGNEW'S    EARLY    LIFE    IX    rHILADELPHIA.  107 

anter ;  his  practice  grew ;  his  consultation  work  steadily  in- 
creased, and  slowly,  but  surely,  he  was  forging  to  the  front.  By 
1860  he  was  acknowledged  to  be  one  of  the  Ibremost  of  Phila- 
delphia surgeons. 

Undoubtedly,  one  reason  why  his  reputation  was  so  firmly 
established  was  because  of  its  natural  growth.  It  rested  on  a 
foundation  of  the  broadest  and  firmest  description.  He  did  not 
buy  his  way  into  a  professorship ;  nor  did  the  influence  of  his 
friends  or  family  put  him  there.  Dr.  Agnew's  progress  corre- 
sponded to  his  own  ideas  and  beliefs.  He  has  frequently  stated 
that  "  promotion,  to  be  permanent  and  successful,  must  be  of 
slow  growth." 

He  did  not  attempt  to  attract  the  attention  of  the  public  to 
himself  by  any  eccentricity  of  conduct,  speech,  or  dress.  He  did 
not  utilize  the  newspapers  to  force  liis  learning  and  attainments 
upon  the  reading  world.  He  instinctiyely  ayoided  such  reputa- 
tion, and  always  felt  a  gentle  contempt  for  "newspaper  doctors." 
He  realized  the  hollow  mockery  of  the  false  position  of  those 
physicians  whose  true  qualities  are  known  to  the  rank  and  file 
of  their  profession,  but  who  win,  now  and  then,  from  the  public 
a  false  estimate  which  sets  them  on  dangerous  leyels  of  apparent 
competence. 

During  the  decade  that  Dr.  Agnew  taught  at  the  School 
of  Anatomy,  he  was  not  wholly  absorbed  by  that  work,  exhaust- 
ing and  exhaustiye  as  it  was  ;  on  the  contrary,  he  was  quite 
actiye  in  other  branches  of  medical  endeayor. 

In  all  the  fields  of  actiyity  in  which  he  worked,  Dr. 
Agnew's  connection  with  hospital  duties  forms  a  large  part  of 
the  history  of  his  life. 

The  greater  portion  of  the  most  yaluable  surgical  work 
performed  by  Dr.  Agnew  was  done  in  the  surgical  wards  of  the 
various  hospitals  with  which  he  was  connected  from  time  to 
time.  He  was  connected  as  surgeon,  first,  with  the  Philadel- 
])hia  Hospital,  from  185-i  to  1865 ;  with  the  "Wills'  Eye  Hospital, 
from  186-1  to  1868;  with  the  Pennsylyania  Hospital,  from  1865 


108  LIFE   OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

to  1871,  and  from  1877  to  1884.  He  was  surgeon  to  the 
Orthopedic  Hospital  from  its  inception,  in  1868,  until  1871, 
when  his  increasing  duties  compelled  his  resignation,  although 
he  remained  consulting  surgeon  until  his  death.  His  service  at 
the  University  Hospital  dates  from  its  erection,  1873-74,  until 
his  death.  In  addition,  during  the  Civil  War  he  had  a  most 
extensive  and  valuable  hospital  experience. 

At  the  majority  of  these  hospitals  the  attending  physician 
acts  in  a  dual  capacity, — as  a  practitioner  in  charge  of  patients, 
and  as  a  teacher  demonstrating  the  various  phases  of  disease 
and  their  treatment  to  the  students.  It  is  customary  to  have 
Wednesday  and  Saturday  morning  cliniques,  at  which  the  differ- 
ent physicians  on  the  staff  are  given  opportunities  to  perform  this 
latter  duty.  It  forms  a  great  training-school  for  those  gentle- 
men who  are  anxious  to  review  and  classify  their  own  knowl- 
edge and  learn  to  impart  it  to  others. 

The  variety  of  operations  which  he  performed  during  this 
long  period  of  service  and  the  number  of  patients  under  his 
care  were  countless,  many  thousands  of  cases  being  under  his 
charge  during  these  many  years  of  faithful  work. 

The  first  hospital  in  point  of  time  with  which  Dr.  Agnew 
was  connected  was  the  official  hospital  of  the  City  of  Philadel- 
phia, called  the  "  Philadelphia  Hospital,"  and  popularly  known 
as  "  Blockley,"  from  the  district  in  which  it  was  erected.  He 
was  elected  to  this  hospital  in  1854,  two  years  after  assuming 
control  of  the  School  of  Anatomy.  This  hospital,  one  of  the 
largest  in  the  world,  with  its  four  thousand  beds,  is  peculiarly 
rich  in  all  clinical  material.  Its  fame  has  spread  all  over  the 
continent.  As  such,  it  is  a  fortunate  berth  for  the  ambitious  and 
enterprising  physician  or  surgeon. 

As  referred  to  humorously  by  Dr.  Agnew  in  his  speech  at 
his  jubilee  banquet,  the  Philadelphia  Hospital  had  closed  its 
doors  to  students  of  medicine  in  1845.  In  the  lecture  on  the 
"Medical  History  of  the  Philadelphia  Almshouse,"  delivered  at 
the  opening  of  the  clinical  lectures,  October  15,  1862,  by  Dr. 


Dk.  Agnew  is  ISoS. 


DR.    AGNEW'S   EARLY    LIFE    IN    rHILADELPHIA.  109 

Agnew,  and  published  by  request  of  the  Board  of  Guardians, 
the  following  amusing  account  of  the  incident  which  caused  the 
abolishment  of  clinical  instruction  at  the  Philadelphia  Hospital 
for  nine  years  is  given  : — 

"  The  30th  of  June,  1845,  is  somewhat  remarkable  in  con- 
sequence of  the  culmination  of  the  trouble  which  had  been 
developing  for  some  time.  The  Resident  Physicians  were 
boarded  at  the  table  of  the  steward,  where,  as  I  understand,  in 
consequence  of  the  want  of  due  formality  in  the  destruction  of 
an  unfortunate  cockroach,  which  had  rashly  taken  a  cut  across 
the  table,  instead  of  going  around  it,  these  gentlemen  became 
indignant  and  demanded  of  the  Managers  to  be  transferred  to 
the  table  of  the  matron.  Their  refusal  to  comply  w'ith  this 
request  determined  a  unanimous  resignation,  leaving  the  hos- 
pital unprovided  with  any  medical  assistance.  The  evening  of 
that  day  Drs.  Horner  and  Clymer  attended  and  prescribed  for 
the  sick.  Here  was  the  causus  belli,  and  the  Managers  promptly 
passed  a  resolution  of  dismissal. 

"  With  the  hope  of  adjusting  these  difficulties  a  joint 
meeting  was  called  for  July  2d,  at  which  Drs.  Jackson,  Horner, 
Clymer,  Gillingham,  and  Pancoast  attended,  representing  as  a 
committee  the  Medical  Board.  Dr.  Jackson,  who  seems  to  have 
been  the  advocate  in  the  case,  spoke  in  behalf  of  the  committee, 
urging  the  Managers  to  allow  the  Residents  to  remain,  at  least 
until  their  places  could  be  properly  supplied,  and  declining  to 
pass  any  censure,  or  interfere  in  any  way  in  the  matter  of  per- 
sonal conflict  between  the  Residents  and  Guardians,  as  foreign 
altogether  to  their  legitimate  jurisdiction. 

"  The  Guardians,  however,  were  inexorable,  and  refused  to 
recede  from  their  dismissal,  thus  forever  closing  the  door  of  com- 
promise. The  seceders,  after  retiring,  availed  themselves  of  the 
columns  of  the  Ledger  newspaper,  in  which  there  appeared  a 
card  betraying,  to  say  the  least  of  it,  a  good  deal  of  youthful 
indiscretion. 

"  On  the  same  day  of  this  meeting  Mr.  Flanagan  offered 
the  following  resolution  : — 


110  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

" '  Resolved,  That  the  Hospital  Committee  be  requested  to 
inquire  into  the  expediency  of  reorganizing  the  Medical  Depart- 
ment of  the  house,  and  report  to  this  Board.' 

"  On  the  21st  of  July  that  report  was  made,  which,  after 
going  over  the  ground  of  the  trouble,  recommended  the  abolish- 
ment of  the  Medical  Board  and  the  substitution  of  a  chief  resi- 
dent and  assistant  resident  physician,  and  two  consulting  phy- 
sicians and  surgeons.  On  September  15th  the  report  was  taken 
up  and  passed,  modified  as  follows :  '  After  the  first  of  October, 
1845,  there  shall  be  one  chief  resident  physician,  at  a  salary  of 
$1800  per  annum ;  one  consulting  surgeon,  one  consulting*^ 
physician,  one  accoucheur,  each  at  a  salary  of  $100  a  year.' 

"  What  great  results  proceed  from  small  and  unlikely 
causes!  Who  would  have  thought  that  the  ofiicial  existence 
of  a  medical  board  composed  of  the  best  and  ablest  men  in  their 
various  departments  on  the  continent  would  be  suspended  on 
the  life  of  a  contemptible  cockroach! 

"  In  this  manner  the  doors  of  the  Philadelphia  Hospital, 
as  a  school  of  instruction,  were  sealed  for  nine  years." 

On  the  1st  of  May,  1854,  the  Philadelphia  County  Medical 
Society  addressed  a  communication  to  the  Board  of  Guardians  of 
this  hospital,  asking  that  its  doors  be  re-opened  for  medical 
instruction.  This  document,  although  forcibly  expressed,  pro- 
duced no  change  in  the  views  of  that  body.  In  August  of  the 
same  year  Dr.  John  J.  Peese,  Registrar  of  the  Medical  Faculty 
of  Pennsylvania  Medical  College,  communicated  with  the  Board 
of  Guardians  on  the  same  subject,  and  guaranteed,  if  its  wards 
were  opened  to  public  instruction,  the  sale  of  fifty  tickets  from 
that  school  alone. 

These  appeals  liad  some  weight  with  the  Guardians,  but,. 
in  Dr.  Agnew's  opinion,  it  was  to  Drs.  Henry  H.  Smith,  R.  A. 
F.  Penrose,  and  James  L.  Ludlow  that  the  profession  in  Phila- 
delphia and  the  country  at  large  were  indebted  for  the  re-estab- 
lishment of  the  clinical  school  within  tlie  walls  of  this  institution. 
Dr.  Agnew  modestly  made  no  mention  of  his  own  eff"orts  in 


DR.    AGNEW'S   EARLY    LIFE    IN    PHILADELPHIA.  Ill 

this  direction,  for  he  felt  that  he  was  comparatively  a  stranger 
in  the  city,  and  that  he  had  no  influence  whatsoever;  but  other 
reports  gave  him  equal  claim  with  these  three  in  the  success  of 
this  opening. 

Consequently,  on  the  6th  of  September,  1854,  the  rules  for 
the  government  of  the  cliniques  were  reported,  and  arrangements 
were  made  for  the  election  of  two  additional  surgeons  and  phy- 
sicians. On  this  day  the  Guardians  elected  Drs.  J.  L.  Ludlow 
and  Robert  Coleman  as  physicians,  and  Drs.  Henry  H.  Smith 
and  D.  Hayes  Agnew  as  surgeons.  On  the  30th  of  October 
the  staff  was  increased  by  the  appointment  of  Dr.  R.  A.  F. 
Penrose  as  obstetrician.  Tickets  of  admission  were  fixed  at 
$10,  including  transportation  to  the  hospital  two  days  in  the 
week — AYednesday  and  Saturday — for  four  months.  The 
Westchester  Railroad,  which  passed  through  the  grounds  of 
the  institution,  was  just  being  completed,  and  an  arrangement 
was  made  with  the  superintendent  to  run  cars  from  Broad  and 
Market  Streets  to  some  point  opposite  the  building,  on  the  days 
of  the  clinical  lectures.  The  second  week  in  October,  1854,  an 
immense  train  left  Broad  Street,  filled  to  overflowing  with  medi- 
cal students,  to  witness  the  inauguration  of  this  important  event. 

Dr.  Agnew  has  stated  that  he  believed  this  train  to  have 
been  the  first  to  have  passed  over  the  long  trestle-work  support- 
ing the  road  across  the  meadows  of  this  property.  There  were 
at  least  700  persons  present  in  the  old  amphitheatre  when  the 
first  clinique  was  held  by  the  new  staff.  The  affairs  of  the 
Philadelphia  Hospital,  never  particularly  tranquil  at  any  time, 
were  rudely  disturbed  when,  in  1856,  clinical  instruction  was 
again  abolished.  In  the  summer  of  1857,  the  visiting  mem- 
bers of  the  entire  medical  organization  resigned,  several  of 
the  resident  physicians  withdrew,  and  again  the  institution 
ceased  to  administer  to  the  wants  of  the  medical  students  of 
Philadelphia. 

In  1858  it  was  proposed  to  re-establish  the  course  of 
clinical  lectures,  and,  on  the  22d  of  November,  1858,  the  Guar- 


112  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

dians  again  revived  the  courses  of  medical  instruction,  and 
elected  Drs.  Joseph  Carson,  J.  B.  Biddle,  J.  Aitken  Meigs,  and 
Samuel  Dickson,  lecturers  on  clinical  medicine;  Drs.  John  Neill, 
W.  S.  Halsey,  Richard  J.  Levis,  and  D.  Hayes  Agnew  on  clini- 
cal surgery;  and  Drs.  R.  A.  F.  Penrose  and  E.  McClellan  on 
obstetrics  and  diseases  of  women  and  children.  Dr.  Dickson's 
health  did  not  allow  him  any  increase  of  his  labors ;  so  he 
resigned,  and  in  his  place  Dr.  J.  M.  Da  Costa  was  elected. 

On  the  4th  of  July,  1859,  the  old  Board  of  Guardians,  which 
for  many  years  had  been  elected  by  popular  vote,  was  abolished, 
and  a  new  board,  consisting  of  twelve  members  appointed  by 
the  Courts  and  Councils,  came  into  power.  This  organization, 
consisting  of  the  most  respectable  and  intelligent  gentlemen  in 
the  community,  entered  upon  the  work  of  reform,  after  a  care- 
ful survey  of  the  field.  As  a  result  of  their  investigations,  they 
placed  the  hospital  department  under  the  charge  of  twelve 
members,  consisting  of  physicians,  surgeons,  and  obstetricians, 
who  were  to  visit  the  institution  four  times  a  week.  The  elec- 
tion of  these  officers  took  place  on  the  8th  of  August,  1859,  at 
which  Drs.  James  L.  Ludlow,  William  F.  Mayburry,  Charles 
P.  Tutt,  and  Robert  Lucket  were  elected  to  constitute  the 
medical  staff;  Drs.  S.  W.  Gross,  Richard  J.  Levis,  Robert 
Kenderdine,  and  D.  Hayes  Agnew,  the  surgical  staff;  and  Drs. 
R.  A.  F.  Penrose,  John  Wiltbank,  William  D.  Stroud,  and 
Louis  Harlow,  the  obstetrical  staff.  On  the  24th  of  September, 
1860,  the  wards  of  tlie  hospital  were  again  tlirown  open,  this 
time  for  free  clinical  instruction. 

The  cliniques  at  the  Philadelphia  Hospital  were  held 
originally  in  the  Insane  Department ;  they  were  afterward  held, 
commencing  in  the  winter  of  1860-61,  in  a  new  building  built 
for  the  purpose.  This  clinique-room,  which  was  described  at 
the  time  as  elegant  and  commodious,  was  anything  but  con- 
venient and  pleasant  to  either  the  operator  or  the  students.  The 
accommodations  were  most  cramped  and  the  ventilation  was  so 
wretched  that,  at  times,  it  was  almost  impossible  to  stay  in  the 


DR.    AGNEW'S    EARLY    LIFE    IN    PHILADELPHIA.  113 

room  on  account  of  the  closeness  of  the  ah*.  This  serious  defect 
has  recently  been  remedied  by  the  erection  of  a  new  clinique- 
building-  within  the  present  year. 

It  is  interesting  to  note,  in  the  records  of  the  reports  to  the 
Eoard  of  Guardians,  tliat  during  these  years  Drs.  Agnew  and 
Kenderdine  were  the  only  surgeons  who  made  complete  reports 
of  their  surgical  work.  In  1865  Dr.  Agnew  resigned  his  posi- 
tion as  physician  and  teacher  in  this  school,  Drs.  Gross  and 
Kenderdine  going  off  at  the  same  time. 

Dr.  Agnew  established  the  Pathological  Museum  in  this 
hospital  and  was  its  first  Curator.  He  retained  this  position, 
after  giving  up  his  surgical  post,  until  1867.  On  January  1, 
1867,  he  presented  a  report  on  the  flourishing  condition  of  this 
museum,  while  under  his  care,  to  the  Board  of  Guardians.  This 
was  the  last  of  several  letters  on  this  subject  addressed  by  him  to 
this  Board.  He  was  succeeded  in  this  position  by  Dr.  William 
Pepper.  During  the  fifties  this  hospital  was  the  only  one  with 
which  Dr.  x\gnew  ■was  connected.  He  received  no  other  hospital 
appointment  until  the  outbreak  of  the  Civil  War. 

As  a  writer,  Dr.  Agnew  was  not  prolific.  Excepting  his 
treatise  on  surgery,  he  wrote  but  very  little.  Nearly  all  of  his 
published  articles  were  written  m  pursuance  of  some  purpose, 
such  as  an  address  before  a  society,  or  to  give  utterance  to  his 
views  on  some  subject  important  at  the  moment.  The  first 
book  published  by  Dr.  Agnew  was  prepared  to  aid  his  students 
m  their  study  of  anatomy.  "  Agnew's  Anatomy,"  as  it  is  popu- 
larly called,  or,  with  its  full  title,  "  Practical  Anatomy :  A  Xew 
Arrangement  of  the  London  Dissector,  with  Numerous  Modifi- 
cations and  Additions,"  was  first  issued  by  J.  B.  Lippincott  & 
Co.,  in  August,  1856.  Possibly,  with  the  memory  of  Professor 
Horner's  method  of  teaching  anatomy  in  his  mind,  Dr.  Agnew 
prepared  this  concise  volume  "  with  an  eye  single  to  the  faithful 
economy  of  the  student's  time,"  believing  that  a  dissector  suited 
to  the  wants  of  American  students  should  be  much  more  con- 
densed than  those  in  general  use. 


114  LIFE   OF    D.    HATES   AGNEW,    M.D.,    LL.D. 

Dr.  Agnew  modestly  called  the  work  "a  new  arrange- 
ment of  the  'London  Dissector,'"  when,  hi  reality,  he  changed 
completely  this  famous  volume.  The  treatment  of  the  subject 
was  entirely  altered  and  the  system  of  nomenclature  changed. 
This  work  was  not  intended  to  teach  the  student  anatomy,  but 
it  was  to  be  taken  to  the  dissecting-table,  where  it  was  to  be 
consulted  by  the  student.  It  was  an  anatomical  libretto.  It 
showed  him  how  to  learn  anatomy  from  the  cadaver ;  as  such 
it  is  a  most  excellent  work,  still  used  occasionally  by  students. 

This  modest  little  volume  compares  favorably  with  the 
more  elaborate  publications  on  the  same  subject  at  the  present 
day.  The  first  edition  was  quite  rapidly  exhausted,  compelling 
Dr.  Agnew  to  publish  a  second  revised  edition  in  1867,  in 
which  he  still  compressed  the  matter  into  as  small  a  compass 
as  possible. 

His  first  article  published  in  a  medical  journal  appeared  in 
the  Medical  and  Surgical  Reporter,  October  15,  1858,  in  which 
he  made  report  of  a  case  of  facial  neuralgia  successfully  treated 
by  excision  of  the  inferior  maxillary  nerve. 

It  was  the  custom  of  the  medical  journals  of  that  day  to 
report  more  fully  than  is  done  at  present  the  clinical  lectures  of 
the  various  professors,  many  of  the  reports  of  Dr.  Agnew's  ser- 
vice at  the  Philadelphia  Hospital  and  at  the  University  of  Penn- 
sylvania, where  he  frequently  substituted  for  Dr.  H.  H.  Smith, 
then  Professor  of  Surgery,  being  published.  The  class  of  cases 
operated  on  at  this  time  by  Dr.  Agnew  were  most  varied, — 
hernia,  lachrymal  fistula,  cataract,  removal  of  cancer,  etc., — 
while  he  included  such  special  subjects  as  the  treatment  of 
skin,  throat,  nose  diseases,  etc. 

In  the  issue  of  the  Medical  and  Surgical  Reporter  for 
April,  1859,  Dr.  Agnew  gave  his  first  communication  on  the 
subject  of  "  Regional  Anatomy  in  its  Relations  to  Medicine  and 
Surgery."  It  was  Dr.  Agnew's  dream  that  anatomy  should  be 
more  closely  and  practically  united  with  the  work  of  the  prac- 
tising physician ;   and  in  this  series  of  articles  which  he  com- 


DR.    AGNEW'S    EARLY    LIFE    IN    PUILADELrUIA.  115 

menced  this  year,  he  hoped  to  show  that  the  subject  of  anatomy 
was  so  important  to  the  ordinary  practitioner  that  a  good  ana- 
tomical education  would  uicrease  his  powers  of  diagnosis  and 
treatment,  not  merely  in  surgical  but  also  in  medical  diseases. 

In  the  next  few  volumes  of  the  Medical  and  Surgical  Re- 
porter he  continued  these  papers ;  so  thoroughly  did  he  go  into 
this  subject  that,  although  he  frequently  published  these  arti- 
cles as  often  iis  every  week  for  two  years,  yet,  at  the  end  of  this 
time,  although  he  began  with  the  head,  he  had  not  finished  this 
division  of  his  topic.  The  illustrations  which  he  used  to  illu- 
minate his  thoughts  were  grouped  in  his  clear,  inimitable 
manner.  In  1862-63  the  increase  of  his  duties  incident  to  the 
Civil  War  broke  off  his  communications  on  this  question,  and  it 
was  not  until  1864  that  he  was  again  enabled  to  publish  two 
papers  on  this  subject ;  but  here,  again,  his  duties  increased, 
and  he  was  never  able  to  complete  the  series.  This  is  a  distinct 
loss  to  medicine,  for  it  was  his  intention  to  republish  the  series 
in  book  form.  It  was  his  desire,  after  he  retired  perma- 
nently from  the  University,  to  return  to  this  favorite  topic.  He 
had  in  course  of  preparation,  at  the  time  of  his  death,  an  article 
on  this  subject,  for  which  space  had  been  reserved  in  the 
University  Medical  Magazine. 

The  following  remarks  in  relation  to  this  series  of  articles 
were  published  in  the  Kortli  American  Medical  Reporter.,  a  Xew 
York  journal  of  the  period  : — 

"  The  series  of  illustrated  papers,  of  seven  of  which  we  have  imper- 
fectl}''  indicated  the  contents,  will,  if  completed,  form  the  best  body  of 
practical  anatomy  extant.  These  papers  wonderfully  approach  actual 
work,  most  perfectly  bringing  back  to  the  mind  the  dimmed  impressions 
of  actual  dissection  ;  while  of  the  '  bearings  and  practice  '  there  are 
single  paragraphs  to  be  found,  so  far  as  we  know,  in  no  printed  book  in 
the  world,  making  them  worth,  to  an}'  practitioner,  more  than  the 
amount  of  the  year's  subscription  to  the  journal  containing  these  practi- 
cally invaluable  communications.  Collected  in  a  volume,  they  form,  as 
far  as  they  go,  a  fair  set-otf  in  tiie  English  language  to  Hyrtl's  '  Hand- 
bnch  '  in  the  German." 


116  LIFE   OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

The  only  other  pubhcations  from  Dr.,  Agnew's  pen  during 
the  fifties  were  the  series  of  annual  valedictory  lectures  to  his 
classes,  published  at  their  request ;  a  pamphlet  on  "  Theatrical 
Amusements,  with  Some  Remarks  on  the  Rev.  Henry  W.  Bel- 
lows' Address  before  the  Dramatic  Fund  Society,"  in  1857;  and 
an  obituary  notice  on  the  late  Frederick  S.  Geiger,  M.D.,  in  the 
Medical  and  Surgical  Reporter,  May  14,  1859. 

Dr.  Agnew's  valedictory  address  to  the  anatomical  class  of 
the  Philadelphia  School  of  Anatomy,  on  February  19,  1856, 
affords  an  opportunity  to  estimate  intelligently  his  knowledge, 
his  beliefs,  and  his  style  at  this  period,  and  at  the  same  time  it 
expresses  his  views  on  the  duties  and  privileges  of  a  physician : — 

"  Gentlemen  : 

"  This  evening  we  bring  our  instructions  in  the  lecture-room 
to  a  close.  In  all  things  I  recognize  a  superintending  Provi- 
dence, by  which  I  have  been  enabled,  amid  many  and  varied 
engagements,  some  indeed  the  saddest  of  my  life,  to  stand  here 
in  my  place  at  each  appointed  hour  to  communicate  the  great 
lessons  of  a  branch  which  constitutes  the  substructure  of  medi- 
cine. In  taking  a  retrospect  of  the  last  few  months,  there  are 
many  points  on  which  it  is  pleasant  to  linger,  and  among  these 
I  assure  you  there  are  none  which  kindle  more  kindly  associa- 
tions, and  which  I  rejoice  to  have  this  public  opportunity  to  ac- 
knowledge, than  the  unexceptionable  decorum,  courteous  atten- 
tion, and  untiring  industry  of  the  very  large  class  who  have 
honored  me  by  their  presence, 

"  In  closing  our  winter  course  of  instruction,  I  cannot  allow 
the  present  opportunity  to  pass  away  without  dropping  a  few 
observations  such  as  the  time,  the  place,  and  the  occasion  sug- 
gest. Disclaiming  all  intention  to  indulge  in.  heartless  compli- 
ment, I  should  do  great  injustice  to  you,  and  violence  to  my 
own  feelings,  did  I  refrain  to  acknowledge  in  the  kindest  man- 
ner the  uniform  courtesy,  good  feeling,  and  attention  which  have 
characterized  your  demeanor   toward  one  who,  in  an  honest 


DR.    AGNEW'S    EARLY    LIFE    IN    PHILADELPHIA.  117 

conscience,  has  labored  to  instruct  you  in  a  branch  which  lies 
at  tlie  foundation  of  a  medical  education. 

"  For  very  many  years  the  department  of  Anatomy  has  been 
taught  within  these  humble  walls  by  many  masters  of  our  Art. 
Some  have  gone  to  their  reward,  others  remain  as  living  and 
successful  expounders  of  their  branch,  whilst  those  who  have 
drawn  wisdom  from  their  teachings  are  found  occupying  every 
position,  and  planted  over  every  portion  of  our  great  and  happy 
country.  But  a  very  few  years  ago  I  entered  this  room  as  a 
teacher,  and  that  single  front  seat  furnished  ample  accommoda- 
tions for  my  audience.  Every  succeeding  year  has  added  largely 
to  its  numbers,  and  it  now  constitutes  the  largest  private  class 
in  this  country;  one  which,  for  intelligence,  application,  and  all 
the  requisites  for  gentlemanly  bearing, — I  say  it  in  no  spirit  of 
boasting, — has  not  its  superior  in  the  world. 

"  There  is  something  of  more  than  ordinary  interest  and 
solemnity  in  the  rupture  of  an  intercourse  which  has  grown  and 
strengthened  by  those  affinities  and  sympathies  naturally  spring- 
ing up  from  the  prosecution  of  subjects  of  common  investigation 
and  interest.  A  few  more  days  and  most  of  you  will  have 
turned  your  backs  upon  the  scenes  which  have  become  familiar 
as  haunts  of  study. 

"  I  can  picture  to  my  mind  the  various  feelings  which  agitate 
your  bosoms.  Some  filled  with  the  enthusiasm  of  the  Doctorate 
long  for  the  opportunity,  like  some  valiant  knight,  to  test  the 
temper  of  their  armor  in  the  tournament  of  medical  conflict. 
Others  long  for  the  renewal  of  that  holy  and  friendly  interchange 
of  feelings  which  clusters  around  the  sacred  circle  of  home. 
There  is  a  charm  and  power  about  this  familiar  word  which 
exerts  a  most  mysterious  influence  over  the  human  mind. 

"  Who  has  not  read  and  wept  over  that  beautiful  and  touch- 
ing description  of  Xenophon,  where  the  hacked  and  scarred 
Greeks,  after  enduring  untold  hardships,  and  scathed  by  the 
fortunes  of  war,  in  their  homeward  return  first  caught  a  glimpse 
of  the  broad  waters  which  washed  the  shores  of  their  native 


118  LIFE   OF   D.    HATES   AGNEW^,    M.D.,    LL.D. 

land,  and  rushed  into  its  friendly  bosom  with  the  impetuous  joy 
of  the  pilgrim  enthusiast  who,  coming  from  the  ends  of  the  earth, 
descries  in  the  distance  the  banks  of  his  sacred  Jordan !  The 
inspiration  of  this  most  praiseworthy  sentiment  cements  the 
heart  to  forms  and  principles ;  it  is  perpetuating  in  all  its  ten- 
dencies ;  it  constitutes  the  bulwark  of  civil  liberty,  and  under 
its  power  a  people  become  terrible  in  war  and  influential  in 
peace.  It  is  the  paradoxical  embodiment  of  strength  in  division 
— harmony  in  disagreement.  The  idea  is  happily  expressed  by 
Goldsmith,  in  his  '  Traveller' : — 

'' '  The  slinddering  tenant  of  the  frigid  zone 
Boldly  proclaims  that  happiest  spot  his  home ; 
Extols  the  treasures  of  his  stormy  seas, 
And  his  long  nights  of  revelry  and  ease. 
The  naked  negro,  panting  at  the  Line, 
Boasts  of  his  golden  sands  and  palmy  wine. 

Such  is  the  patriot's  boast  where'er  we  roam, 
His  first  best  country  ever  is  at  home.' 

"You  have,  gentlemen,  adopted  the  profession  of  medicine 
as  the  pursuit  of  your  life,  and  I  doubt  not  it  is  your  desire  to 
make  the  resources  of  that  profession  tributary  to  your  name, 
your  wealth,  and  the  happiness  of  your  race. 

"  I  am  aware  it  is  customary  to  exalt  the  disinterestedness 
of  medicine,  so  as  to  exclude  all  considerations  of  self;  to  libel 
name  as  vanity,  and  gold  as  contemptible  dross ;  but  I  have  no 
objection  to  that  selfishness  which  would  rather  provide  for  one's 
own  house  than  be  esteemed  a  heathen  man.^  And  even  were 
it  true  either  in  principle  or  fact,  the  public  are  not  prone  to 
sin  very  grievously  against  your  dignity  or  conscientious  deli- 
cacy. If,  however,  you  enter  upon  the  duties  of  your  calling 
entertaining  such  puerile  fancies,  your  mind  will  soon  become 
disabused.  And  why  nof?  Are  we  not  made  of  the  same  stuff 
as  other  men'?  We  cannot  live  as  a  plant,  upon  the  air  ;  nor  can 
we  subsist  upon  the  benisons  of  grateful  convalescents. 

1  I  Timothy,  5th  chapter,  8th  verse. 


DR.    AGNEW'S   EARLY    LIFE    IN    PHILADELPHIA.  119 

"  May  we  not  exclaim  with  the  Jew  in  the  '  Merchant  of 
Venice  ' — Hath  not  a  Doctor  eyes '?  Hath  not  lie  hands,  organs 
and  dimensions,  affections,  passions,  as  others  have "?  If  you 
prick  us,  do  we  not  bleed  ]  If  you  tickle  us,  do  we  not  laugh, 
feed  with  the  same  food,  and  hurt  with  the  same  weapons'?  It 
so  happens  that  the  Great  Creator  most  generally  connects  our 
duties  with  our  interests;  so  that,  the  more  ardently  we  prose- 
cute our  partialities,  the  more  do  we  contribute  to  the  general 
good  of  the  human  family. 

"  In  medicine,  as  in  every  other  occupation,  the  first  step  is 
the  most  important.  For  its  successful  prosecution,  qualifica- 
tions of  no  ordinary  character  are  required ;  and  to  have  a  full 
comprehension  of  these  is  a  very  essential  step  toward  success. 
You  all  aspire  to  distinction  in  life.  It  is  a  noble  sentiment, 
and  yet  there  is  none  so  commonly  doomed  to  disappointment. 
Who  can  tell  how  many  professional  hopes  have  vanished  like 
dew  before  the  morning  sun '?  How  many  brilliant  anticipa- 
tions disappointed,  and  noble  plans  miscarried'?  Why  is  this 
the  case '?     Certainly  not  from  a  defect  of  talent. 

"  Not  one  of  the  liberal  professions  comprise  so  large  a  share 
of  talent  as  our  own.  It  brings  into  its  ranks,  in  point  of  edu- 
cation and  manly  endowments,  every  qualification  essential  to 
the  accomplishment  of  any  reasonable  result.  For  the  ex- 
planation we  must  look,  therefore,  not  to  the  want  of  talent, 
but  its  misapplication,  and  a  little  investigation  will  reveal  the 
true  cause.     Let  us  examine  some  of  these  for  a  short  time. 

"  Many  are  prone  to  consider  that,  as  soon  as  they  are 
released  from  their  collegiate  minority,  labor  is  at  an  end  and 
their  education  completed.  They  carry  with  them  the  views 
of  instructors,  adopting  these  as  axioms  in  science  and  undevi- 
ating  rules  for  their  future  practice.  It  is  all  well  to  regard 
with  the  hiohest  consideration  these  teachino-s.  The  idea  that 
they  are  not  worthy  of  your  confidence  and  application  is  not 
for  a  moment  entertained  ;  but  it  is  that  servility  of  conduct,  that 
forfeiture  of  independent  thought,  which  is  to  be  deplored  and 


120  LITE   OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

condemned ;  for  it  is  the  sure  precursor  of  a  routinist,  who  is 
ever  content  to  follow,  never  aspires  to  lead.  It  should  be  the 
first  great  duty  of  one  just  initiated  into  the  brotherhood  of 
medicine  to  test  the  truth  and  validity  of  the  basis  upon  which 
his  education  has  been  erected.  Our  science  courts  investiga- 
tion— nay,  challenges  examination.  It  is  not  to  be  supposed 
that  the  multitude  of  opinions  gathered  into  the  literature  of 
medicine  would  fail  to  create  doubts  upon  some  points.  These 
are  questions  for  your  own  solution,  and  the  exercise  of  a 
doubt  involves  no  sin.  Indeed,  there  can  be  no  progress  without 
it.  It  has  ever,  and  will  ever,  be  the  great  pioneer  in  all 
reforms. 

"  In  fact,  conformity  of  sentiment  cannot  be  expected.  Men, 
from  their  very  organization,  examine  subjects  from  different 
points  and  in  different  modes,  and  the  various  accumulations 
of  facts  which  are  thus  garnered  into  the  great  depository  of  the 
science  become  the  property  of  some  future  medical  philosopher, 
who  fashions  out  of  them  some  general  law,  whose  every  part 
beams  with  the  harmony  and  light  of  proportion  and  truth. 
Universal  conformity  in  any  department,  even  were  it  possible, 
would  be  fatal  to  progress.  '  What  a  fool  have  I  been,'  ex- 
claimed Charles  V,  when,  to  relieve  the  tedium  of  his  kingly 
exile,  he  amused  himself  in  attempting  to  regulate  a  few 
watches  to  a  common  time.  '  What  a  fool  have  I  been  in 
endeavoring  to  compel  living  men  to  think  alike,  when  I  cannot 
make  two  dumb  watches  keep  time  together!' 

"  It  should  be  remembered  that,  in  espousing  the  profes- 
sion, you  incur  solemn  moral  obligations  which  may  not  be 
lightly  shaken  off.  It  is  no  trivial  consideration  to  assume  the 
management  of  the  health  and  lives  of  a  community.  You 
have  seen  enough  in  your  anatomical  pursuits  to  teach  you  that 
to  comprehend  the  workings  of  so  complex  and  curiously-con- 
structed a  system  as  that  of  man  is  a  task  of  no  mean  magni- 
tude, and  to  fathom  the  laws  by  which  its  mysterious  processes 
are    conducted  requires  all  the  concentration  of  mind,  acute- 


DR.    AGNEW'S   EARLY    LIFE    IN    PHILADELPHIA.  121 

ness  of  observation,  and  philosophical  disposition  of  facts  you 
can  command.  The  expounder  of  your  art  can  hope  to  do  no 
more  than  to  inculcate  principles  which  are  universal  and  gen- 
eral in  their  character.  The  applications  of  these  to  special  con- 
ditions must  depend  for  success  upon  the  logical  correctness  of 
conclusions  formed  by  rigid  analysis. 

"  Inordinate  expectation  from  the  resources  of  the  profes- 
sion is  another  source  of  difficulty.  The  public  are  exacting  in 
their  demands  and  expect  you  to  accomplish  very  many  un- 
reasonable results.  Voltaire's  definition  of  a  Physician  ex- 
presses the  idea :  '  An  unfortunate  gentleman  who  is  expected 
to  perform  a  miracle  every  day  in  reconciling  health  with 
intemperance.' 

"  The  student  enters  upon  duty  as  though  he  had  little  else 
to  do  than  to  level  with  a  stroke  every  enemy  of  human  life. 
Failing  to  accomplish  all  his  sanguine  confidence  would  desire, 
he  loses  faith  in  its  potency  for  good  and  pursues  it  as  a 
trade  rather  than  a  science.  A  moment's  consideration  will 
correct  all  such  unreasonable  impressions.  The  system  is  a 
kind  of  federal  compact,  an  assemblage  of  numerous  distinct 
independencies.  There  are  laws  belonging  to  the  individual 
organs,  and  so  are  there  laws  regulative  of  the  combined  opera- 
tions of  its  parts,  and,  as  each  individual  part  is  considered  sov- 
ereign, one  does  not  entrench  upon  the  other ;  and  as  the  gen- 
eral laws  grow  out  of  the  combined  necessities  of  individual 
portions,  their  influence  must  be  in  a  great  measure  conservative. 

"Interruptions  of  these  laws  constitute  disease;  and  when 
the  quiet  and  normal  exercise  of  the  legitimate  functions  of  an 
organ  have  been  assailed  by  some  enemy  who  secretly  gains 
access  to  the  citadel,  see  how  promptly  all  the  other  portions 
resent  the  injury  and  combine  to  eject  the  intruder !  See  how 
the  skin  mantles  with  generous  indignation  and  sweats  Avitli 
arduous  toil !  How  the  heart  thumps  like  an  imprisoned  giant 
against  the  bars  of  his  cell  and  lashes  the  crimson  torrent  along 
the  shores  of  the  systemic  rivers,  as  if  to  wash  out  the  Aery 


122  LIFE    OF    D.    HAYES   AGNEW,    M.D.,    LL.D. 

foot-prints  of  the  invader !  The  lungs  breathe  a  tempest.  The 
glands,  for  the  most  part,  shut  up  their  bosom  and  refuse  sup- 
plies ;  the  eyes  melt  with  pity  and  shed  tears  of  sympathy.  The 
little  absorbent  traders,  who  visit  all  the  avenues  of  the  body  in 
search  of  wares,  refuse  to  replenish  at  the  great  marts  of  com- 
merce ;  all  work  is  suspended  until  safety  and  peace  is  restored. 

"  What  a  lesson  to  a  people,  citizens  of  a  country  of  dif- 
ferent aggregated  interests  like  our  own!  May  the  same  prin- 
ciples of  fraternity  bind  every  member  to  the  great  centre  of  our 
national  Union,  and  may  its  enemies,  whether  at  home  or 
abroad,  meet  with  the  same  unterritied  rebuke!  Now,  the  ten- 
dency of  deranged  organic  actions  is  generally  sanitary,  and, 
in  a  large  proportion  of  cases,  adequate  to  accomplish  their  own 
relief.  It  is  only,  therefore,  when  these  processes  are  likely  to 
fail  that  medicine  legitimately  interferes.  The  judgment  and 
address  of  the  Physician  consist  not  in  the  administration  of 
remedies,  but  in  knowing  w7ie7i  to  administer ;  not  only  in 
employing  weapons,  but  lolien  to  employ  them.  Habitual 
inattention  to  these  considerations  will  defeat  the  best  intentions 
of  the  profession,  and,  under  the  hue  and  cry  of  an  unsuccessful 
Doctor,  he  too  often  beats  an  inglorious  retreat  into  some  of  the 
innumerable  sinks  of  quackery.  Another  prolific  source  of 
failure  is  the  wide-spread  idea  that  some  lucky  chance  or  acci- 
dental good  future  will  elevate  suddenly  to  position,  as  the 
breaker  catches  upon  its  bosom  the  bubble  of  surf  and  drops  it 
high  upon  the  sea-beach.  How  unlike  our  conduct  in  the 
common  affairs  of  life !  Would  you  linger  at  the  risk  of  starv- 
ation upon  some  barren  island  of  the  sea  in  full  view  of  land, 
with  all  the  materials  to  construct  a  raft  in  profusion  around,  in 
the  hope  that,  perchance,  the  friendly  winds  would  bring  some 
propitious  saiH 

"  Look  into  the  world  of  matter.  Do  the  small  particles 
which  in  the  aggregate  construct  the  glittering  crystal  take  their 
definitive  posts  at  hazard  %  Do  the  elements  which  the  chemist 
brings  into  relation  settle  into  place  by  accident,  and  form  for- 


DR.    AGNEW'S   EAKLY    LIFE    IN    PlIILADELPUIA.  123 

tuitoiisly  the  various  compounds  1  Do  those  brilhant  orbs  wliicli 
sparkle  in  the  vault  of  heaven  move  througli  the  hi<';hways  of 
space,  impelled  by  cliance  1  There  is  no  such  thing.  All  are 
acting  under  laws  emanating  from  the  throne,  as  unalterable 
and  fixed  as  the  God  who  sits  upon  it,  whose  operations  are 
seen  as  well  in  the  mote  which  floats  in  the  sunbeam  as  the 
mightiest  planet  which  wheels  in  his  orbit ;  as  manifest  in  the 
tint  of  an  insect's  wing,  the  creature  of  a  day,  as  in  the  rainbow 
arch  which  spans  the  sky. 

"  Others  toil  in  search  of  specific  agents  wherewith  to  medi- 
cate. They  are  like  those  ancient  philosophers  who  spent  their 
lives  in  the  fruitless  attempt  to  discover  that  magic  stone  which 
was  to  turn  all  the  baser  metals  into  gold.  Or  those  Castilian 
adventurers  who,  led  by  the  Cavalier  Ferdinand  de  Soto,  wan- 
dered over  our  continent  in  quest  of  precious  mines,  or  some 
potent  spring,  whose  recuperative  waters  should  stay  the  march 
of  years  and  clothe  the  body  with  the  bloom  of  perpetual  youth. 
'  Leave  that  to  the  winds,'  said  the  impetuous  Alaric,  in  answer  to 
his  pilot  whither  should  they  turn  their  prow, — '  Leave  that  to  the 
winds;  they  will  be  sure  to  waft  us  to  the  desired  coast.'  There 
can  be  no  greater  mistake,  gentlemen,  than  to  suppose  the  in- 
strumentalities which  lead  to  success  in  other  vocations  of  life 
will  be  suspended  in  favor  of  you.  There  must  be  a  diligent 
and  patient  employment  of  means,  if  you  expect  desired  ends ; 
you  must  invoke  causes  if  you  hope  for  consequences.  It  was 
not  fortune  which  filled  the  world  with  the  name  of  Napoleon. 
All  his  great  successes  and  master-strokes,  as  they  were  wont  to 
be  termed,  were  nothing  more  than  the  execution  of  plans  rigidly 
constructed  in  the  mind  of  the  First  Consul,  both  for  ordinary 
and  extraordinary  circumstances. 

"  It  was  not  chance  which  made  a  great  constitutional  lawyer 
of  Daniel  Webster.  Nor  was  it  chance  which  made  a  Physick  or 
a  Rush  the  ornaments  of  your  own  profession. 

"  Promotion  is  a  plant  of  slow  growth.  The  road  which  leads 
to  distinction  is  rough  and  rugged,  and  many  pilgrims  grow  faint 


124  LIFE    OF   D.    HATES    AGNEW,    M.D.,    LL.D. 

and  sink  by  the  way.  The  grain  does  not  ripen  to  the  perfect 
harvest  by  gentle  gales  and  unbroken  sunshine;  it  must  have  the 
storms,  the  winds,  and  the  frosts  of  heaven.  Navigators  tell  us^ 
and  our  own  intrepid  countryman  and  professional  brother^ 
Kane,  whom  the  world  delights  to  honor,  has  verified  its  truth, 
that  around  the  pole  flows  a  sea  of  open  water ;  to  reach  it,  how- 
ever, the  mariner  must  encounter  icebergs  and  storms.  Just  so 
it  is  with  the  goal  of  scientific  distinction.  It  is  an  inviting  spot 
of  rare  and  dazzling  beauty,  but  to  reach  it  there  are  many  Mont 
Blancs  to  scale. 

"  Still,  let  your  peculiar  difiiculties  be  what  they  may,  history 
has  placed  on  record  examples  for  encouragement.  Is  your  time 
distracted  with  onerous  cares  1  Be  it  so !  Caesar  wrote  his 
Commentaries  and  governed  a  kingdom.  Does  poverty  pinch 
with  its  Shylock  grip]  Poverty  produced  the  immortal  poet 
Dante,  the  '  Iliad '  of  Homer,  the  '  Maxims '  of  Terrence ;  and  the 
owner  of  but  four  acres  of  land,  by  the  unanimous  acclamation 
of  the  Senate,  became  the  Dictator  of  Rome.  There  is  a  power, 
a  moral  sublimity  in  undismayed  perseverance  and  virtue,  which, 
planting  its  shoulder  resolutely  against  the  wheel  of  life,  and  not 
idly  supplicating  the  aid  of  Jupiter,  forces  and  compels  the  world 
to  respect  and  homage. 

"  The  unfortunate  author  of '  Lacon '  has  said  that  many  men 
fail  in  life  from  the  want,  as  they  suppose,  of  those  great  occa- 
sions wherein  they  might  have  shown  their  trustworthiness. 
But  all  such  persons  should  remember  that  before  we  place  wine 
in  a  vessel  we  try  its  integrity  with  water ;  and  it  is  attention  tO' 
what  are  frequently  termed  the  trivial  duties  of  a  profession 
which  paves  the  way  for  higher  advancements.  This  landing 
at  a  single  bound  from  the  cradle  into  mature  manhood  is  one 
of  the  remarkable  characteristics  of  the  age.  In  the  high-crown 
hats,  Shanghai  coats,  and  air  of  noicJmlance,  we  fail  to  recognize 
any  longer  the  boy.  Scarcely  are  many  loosed  from  the  leading- 
strings  of  the  schools,  when  they  appear  as  the  expositors  and 
oracles  of  science.      We  would   not   assert  that  early  genius 


DR.    AGNEW'S    EARLY    LIFE    IX    PHILADELPHIA.  125 

may  not  render  important  contributions  to  our  branch.  Dante 
was  an  author  at  a  very  early  age  ;  Schiller  wrote  an  epic  before 
he  had  attained  his  fifteenth  year ;  Tasso  was  a  prodigy  at  five ; 
and  Mozart  astonished  his  friends  at  three  years  of  age  with 
wonderful  executions  which  foreshadowed  his  future  triumphs. 
Visconti  knew  his  alphabet  at  eighteen  months,  and  ere  he  had 
attained  his  fourth  year  read  fluently  the  ancient  classics. 
Years  have  rolled  away,  and  their  productions  still  stand  as  the 
models  of  our  literature,  gathering  additional  strength  and  bril- 
liancy with  age.  AVhat  think  you  will  be  the  judgment  of 
opinion  two  generations  hence  upon  much  of  our  early  author- 
ship ? 

"  Time  is  the  great  adjudicator ;  it  will  preserve  and  bur- 
nish the  gold,  and  it  will  bury  the  dross.  When  the  immortal 
Kepler  discovered  the  laws  which  harmonize  the  movements  of 
the  heavenlv  bodies,  he  is  said  to  have  exclaimed  •  Whether  mv 
discoveries  will  be  read  by  posterity  or  by  my  contemporaries 
is  a  matter  that  concerns  them  more  than  me.  I  can  wait  a 
century  for  a  reader.  Avhen  God  has  waited  some  thousands  of 
years  for  an  observer  like  myself  V^'e  tlunk  many  care  little 
about  the  decisions  of  the  future  if  they  can  secure  the  approval 
of  the  present. 

"  But  I  fear  I  have  wearied  your  patience,  and,  though  I 
would  feio^n  lins^er  amoni)-  vou.  I  hasten  to  conclude.  Manv  of 
you  are  about  to  enter  the  lists  and  measure  arms  with  the  mul- 
tiplied enemies  of  our  race.  Take  care — take  care  that  your 
armor  befits  you.  The  stripling  shepherd  of  Israel  in  vain 
essayed  to  meet  the  giant  of  Gath  in  the  cumbrous  panoply  of 
Saul ;  and  it  will  be  better  with  you.  as  with  him,  to  venture 
with  the  simple  staff  and  sling  of  unpretense. 

"  There  is  everything  in  preparation.  I  take  it.  no  man 
living,  who  has  carefully  watched  the  drifl  of  hfe,  but  will  have 
marked  certain  periods  when  he  might  have  embarked  in  busi- 
ness with  every  prospect  of  success.  These  may  be  termed 
seasons  of  opportunity.     They  pass  along  some  time  or  other 


126  LIFE   OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

by  every  man's  door.     The  great  secret,  gentlemen,  is  to  be  fully 
equipped,  and  seize  the  moment  when  it  comes. 

" '  We  must  take  the  current  when  it  serves, 
Or  lose  our  venture.' 

"Wherever,  in  the  will  of  Providence,  your  lot  may  be 
cast,  you  have  my  warmest  wishes  for  your  personal  and  profes- 
sional happiness  and  success." 

This  address  was  written  by  Dr.  Agnew  in  one  evening ; 
it  stands  exactly  as  it  was  prepared,  without  corrections  or 
additions. 

At  this  period  a  coincidence  showing  the  unity  of  mind  of 
the  Agnews  upon  religious  subjects  occurred : — 

"  A  Manual  on  the  Christian  Sabbath,"  written  by  Rev. 
John  Holmes  Agnew,  D.D.,  was  published  by  the  Presbyterian 
Board  of  Publication  in  Philadelphia,  in  1852.  In  this  work, 
this  learned  professor  studied  the  institution,  perpetual  obliga- 
tion, change  of  day,  utility  and  duties  of  the  Sabbath.  He 
also  waged  warfare  on  all  Sabbath-breakers  in  most  valiant 
style.  Curiously  enough,  in  the  Appendix  are  abstracts  from 
the  report  of  a  committee  of  the  British  House  of  Commons  on 
the  observances  of  the  Sabbath,  of  which  another  member  of 
the  family.  Sir  Andrew  Agnew,  was  chairman.  In  this  report 
the  cudgels  are  taken  up  in  favor  of  the  Scottish  Sabbath,  and, 
among  other  things,  the  description  given  by  Sir  Walter  Scott 
of  the  Sunday  of  the  Covenanters  is  disputed. 

In  the  latter  part  of  the  fifties,  Dr.  Agnew  was  honored 
by  election  to  membership  in  the  Board  of  Managers  of  the 
House  of  Befuge,  the  appointment  being  made  by  the  Judges 
of  the  Courts  of  the  City  of  Philadelphia.  He  joined,  also,  in 
these  years,  the  Philadelphia  County  Medical  Society  and  the 
College  of  Physicians. 

Keen  eyes  in  the  city  were  fixed  upon  him ;  men  of  skill 
and  eminence  were  talking  about  him.  Signs  of  his  strength 
had  aroused  attention.     Smith  and  Jackson,  then  foremost  in 


DR.    AGNEW'S   EARLY    LIFE    IN    PHILADELPHIA.  127 

their  profession,  had  tested  the  stranger,  and  they  found  what, 
in  after  years,  we  have  all  come  to  know — that  Agnew  never 
failed  when  he  was  tried.  So  the  doors  began  to  open;  the 
doctor  and  surgeon  began  to  be  known  ;  the  path  grew  easier ; 
he  drew  longer  breaths,  and  felt  that  the  battle  was  now  in  his 
own  hands,  under  that  merciful  Providence  whom  lie  had  ever 
trusted,  and  now  trusted  more  than  ever ;  but  those  stern  years 
never  left  his  memory  In  speaking  of  these  days,  he  has  said, 
frequently,  "  The  time  a  man  needs  God  the  most  is  when  he 
feels  that  he  deserves  success  and  doesn't  get  it." 

Work  had  not  ceased  witli  him,  but  it  had  changed  its 
character;  it  was  not  now  a  struggle  for  sustenance,  but  uncon- 
sciously for  supremacy. 


CHAPTEH  VI. 

Dr.  Agnew's  Life  from  1860  to  1870. 

Like  other  Americans,  Dr.  Agnew's  quiet,  tranquil  life  was 
rudely  disturbed  in  1860  by  the  commencement  of  the  terrific 
struggle  of  the  Southern  States  to  separate  themselves  from  the 
Union.  The  part  borne  by  Dr.  Agnew  in  this  conflict  was  no 
small  one.  A  surgeon's  position  in  war-time  is  always  most 
important ;  but  for  his  skill  and  work  the  horrors  of  war,  already 
terrible,  would  be  increased  a  thousand-fold. 

Dr.  Agnew,  in  common  with  many  other  clear-headed  men 
before  the  commencement  of  the  war,  such  as  Abraham  Lin- 
coln, while  in  favor  of  the  abolition  of  slavery,  was  opposed  to 
the  methods  by  which  the  Abolitionists  proposed  to  bring  about 
the  accomplishment  of  this  purpose.  He  believed  thoroughly 
in  the  extinction  of  slavery,  and  had  studied  the  problem  for 
many  years. 

It  seemed  to  him  that  the  removal  of  slaves  to  the  country 
from  which  they  had  originally  come,  in  a  climate  to  which  their 
.constitutions  adapted  them,  with  the  addition  of  all  the  agencies 
of  civilization  to  which  they  had  grown  accustomed,  was  the 
proper  solution  of  the  vexed  slavery  question.  He  was  well 
enough  acquainted  with  the  temper  of  the  South  to  know  that 
the  Abolition  movement  in  itself  tended  inevitably  toward  war, 
and,  possibly,  toward  dissolution  of  the  country.  On  this 
account,  years  before,  he  had  become  an  active  member  of 
the  American  Colonization  Society.  He  had  hoped  that,  in 
the  foundation  of  the  Liberian  Colony,  the  solution  of  this  ter- 
rible question  would  be  found ;  but  as  the  country  was  swept 
along  irresistibly  to  the  terrible  vortex  of  a  civil  war,  the  subject 
of  slavery  and  the  threatened  dissolution  of  the  government 
were  forced  upon  his  attention,  in  the  most  practical  manner, 
before  the  outside  world  had  felt  the  rigors  of  war, — when  he 
(128) 


DR.    AGNEW'S    LIFE    FROM    1860    TO    1870.  129 

lost,  in  a  night,  the  majority  of  his  Southern  students.  At  this 
time  this  action,  together  with  the  request  of  a  portion  of  his 
class  to  hurry  the  course  of  instruction,  led  him  to  speak  on  the 
all-absorbing  question  of  the  abolition  of  slavery.  The  tem- 
perate tone  in  which  he  discussed  this  burning  question  shows 
that  he  had  taken  up  its  study  with  his  characteristic  calmness. 
He  spoke  as  follows  : — 

"  When  I  cast  a  glance  over  these  seats,  I  discover  many  faces 
absent  which  had  grown  familiar  from  the  regularity  of  their  presence. 
This  circumstance  and  also  a  request  from  a  portion  of  the  class  con- 
strain me  to  notice  one  of  the  most  extraordinary  incidents, — one  with- 
out a  precedent  in  the  history  of  this  country, — that  of  a  large  number 
of  educated  young  men,  prosecuting  their  professional  studies,  suddenly 
abandoning  the  institutions  of  one  section  for  those  of  another. 

"  The  question  naturally  presents  itself, — What  circumstances  have 
caused  this  remarkable  action  ?  Have  tiie  schools  of  Philadelphia,  so 
long  famous  for  their  devotion  to  medical  education,  become  degenerate 
plants  of  a  noble  vine?  Have  those,  their  functionaries,  who  now  stand 
forth  as  the  expositors  of  our  art,  lost  their  power  to  charm, — their 
voices  become  mute,  and  their  cunning  departed?  Has  the  Philadelphia 
Hospital, — with  a  population  of  over  three  thousand  souls, — the  Pennsyl- 
vania Hospital,  The  Wills,  and  other  eleomosynar}^  institutions  no  sick, 
no  halt,  no  blind  upon  which  to  demonstrate  the  practical  power  of  med- 
icine, and  inti'oduce  the  student  into  the  beneficent  functions  of  his  pro- 
fession ?  Have  the  resources  so  necessary  to  sustain  a  l)ody  of  zealous 
j-oung  men  during  the  period  of  pupilage  suddenly  become  dried  up  ?  Has 
some  modern  development  cleft  the  great  body  of  medicine  in  twain,  an 
opinion,  separated  by  a  vast,  unbridged  chasm,  created  independent  and 
uncompromising  parties?  Medicine  once  held  her  court  in  Edinburgh^ 
then  her  empire  moved  to  London,  tlien  to  Paris,  and  now,  perhaps,  to 
Vienna;  yet  the  science  was  one,  and  still  so  continues  indissoluble, 
cemented  unity, — the  same  in  Maine  as  at  the  Pacific,  in  Oregon  as  at 
the  Gulf  of  Mexico. 

"  Not  one  of  these  catastrophes  lias  happened.  Then,  to  what 
shall  we  look  for  an  explanation  ?  Wiiatever  other  circumstances  may 
have  conspired  to  bring  about  this  event,  it  cannot  be  doubted  but  tliat 
the  agitation  of  the  long-vexed  question  of  negro  slavery  was  the  excit- 
ing cause.  Long  confined  to  the  arena  of  politics,  tliis  subject  has,  from 
various  influences,  been  rising  in  magnitude,  until  it  has  assumed  an 
importance  full  of  peril,  and,  like  some  miglity  Maelstrom,  it  has  drawn 


130  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D, 

into  its  revolving  currents  all  occupations,  trades,  and  professions.  A 
subject,  therefore,  which  has  become  so  disturbing  an  element  to  the 
peace  of  the  States  ;  which  has  rent  asunder  large  bodies  of  denomina- 
tional Christians ;  which  avows,  with  unblushing  insolence,  the  most 
horrible  doctrines,  inciting  to  riot,  rapine,  and  murder,  and  openly  coun- 
selling and -practicing  resistance  to  the  supreme  authority  of  the  land; 
and  which  even  threatens  the  proscription  of  our  very  seats  of  learning 
on  account  of  their  geographical  relation  to  a  particular  line,  may  well 
challenge  our  most  earnest  attention," 

Continuing  in  this  strain,  Dr.  Agnew  made  a  stirring  ad- 
dress, in  which  he  reviewed  the  past  history  of  the  country,  and 
urged  the  love  of  patriotism  and  forbearance  upon  his  students. 
He  believed  that  the  dissolution  of  the  country  would  be  most 
calamitous.  He  believed  that  it  would  settle  none  of  the  ques- 
tions at  stake ;  that  it  would  doom  the  slave  population  to  the 
most  rigorous  and  most  hopeless  servitude,  and  possibly  to 
entire  extermination.  He  believed  that  the  line  of  separation, 
if  drawn,  would  be  crimson  with  the  blood  of  border  warfare. 
He  felt  that  it  would  be  better  to  have  war,  pestilence,  and 
famine  a  thousand  times  together  than  that  such  a  catastrophe 
should  occur.  In  concluding  this  stirring  address,  he  hoped 
that  all  his  students  would  carry  with  them,  to  whatever  spot 
they  went,  love  and  honor  for  their  country  and  the  memory  of 
his  admonitions. 

He  published,  during  the  winter  of  1860-61,  his  lecture  on 
the  "  Career  of  Baron  Larrey,"  the  great  surgeon  of  the  Napo- 
leonic wars,  in  order  to  present  the  life-work  of  one  who  stood 
pre-eminent  among  military  surgeons, — "  whose  example  may 
serve  as  a  model  for  the  ambition  of  my  professional  country- 
men at  a  period  when  events  portend  a  struggle  of  no  ordinary 
magnitude." 

When  war  was  eventually  declared.  Dr.  Agnew  threw  all 
the  resources  of  his  training  into  the  service  of  the  government. 
From  the  position  of  his  school, — near  the  seat  of  war, — it  at- 
tracted, naturally,  hundreds  of  students  who  were  anxious  to 
complete  their  education  to  such  a  degree  that  they  could  serve 


DR.    AGNEW'S    LIFE    FROM    1860    TO    1870.  131 

as  assistant  surgeons  in  the  army.  The  line  of  teaching  which 
he  had  been  following  on  anatomy  and  surgery  was  exactly 
suited  to  the  requirements  which  they  were  expected  to  meet  as 
army-surgeons.  In  consequence,  countless  surgeons  went  to 
the  war  prepared,  through  the  teachings  and  demonstrations  of 
Dr.  Agnew,  to  aid  their  countrymen,  to  alleviate  their  sufferings, 
and  to  ward  off  disease  and  death. 

On  June  11,  1862,  he  entered  into  contract  with  the  gov- 
ernment for  service  as  Acting  Assistant  Surgeon  in  the  United 
States  Army,  on  duty  at  Satterlee  General  Hospital,  in  West 
Philadelphia.  On  July  17,  1862,  he  was  transferred  to  duty 
at  the  Hestonville  General  Hospital.  On  October  26,  1862,  his 
contract  terminated,  he  being  appointed  Surgeon  of  Volunteers, 
to  date  from  October  6,  1862.  He  continued  on  duty  at  this 
hospital,  as  Surgeon-in-Charge,  until  April  7,  1863,  when  his 
resignation  was  accepted,  as  his  professional  services  as  lecturer 
on  anatomy  and  operative  surgery  did  not  permit  of  his  transfer 
to  duty  elsewhere.  From  December,  1862,  to  January,  1863, 
he  was  also  a  member  of  the  Medical  Examining  Board  for 
Volunteer  Surgeons.  On  August  11,  1863,  he  again  entered 
into  contract  for  service  as  Acting  Assistant  Surgeon,  being 
assigned  again  to  duty  at  Satterlee  General  Hospital,  in  West 
Philadelphia.  This  contract  was  terminated  October  7,  1863. 
On  May  12,  1864,  he  entered  into  contract  for  service  as 
Consulting  Surgeon,  on  duty  at  the  Mower  General  Hospital, 
Chestnut  Hill,  Philadelphia,  where  he  remained  on  duty  for 
nearly  fourteen  months, — until  July  8,  1865, — when  his  con- 
tract was  terminated. 

As  can  be  seen  from  this  official  report  of  Dr.  Agnew's 
service  during  the  Civil  War,  his  first  connection  with  a  military 
hospital  was  with  the  Satterlee  General  Hospital ;  but  he  was 
transferred,  after  a  month  of  service,  to  the  Hestonville  General 
Hospital,  where  he  was  Surgeon-in-Charge. 

The  United  States  jNIilitary  Hospital  at  Hestonville  was 
opened  in  July,  1862,  with  Dr.  Agnew  as  Surgeon-in-Charge, 


132  LIFE    OF    D.    HAYES   AGNEW,    M.D.,    LL.D. 

and  with  Dr.  John  W.  Lodge  as  Assistant  Surgeon  and  Execu- 
tive Officer.  The  large  room  over  the  depot  of  the  Race  and 
Vine  Streets  Passenger  Railway  Company  was  utilized  for  this 
purpose,  containing  two  hundred  beds.  The  place  was  not  well 
adapted  for  hospital  purposes  at  first,  but  later  the  room  was 
divided  and  the  various  offices  attached.  Under  the  direction 
of  the  Surgeon-in-Charge  it  soon  became  one  of  the  best  in  the 
city.  It  was  here  that  Dr.  Agnew  had  his  first  experience  with 
military  surgery  and  the  management  of  gunshot  wounds.  He 
bestowed  the  greatest  care  on  all  his  cases ;  his  interest  in  their 
condition  and  welfare  was  absorbing.  This  was  a  new  field  for 
American  surgeons ;  it  was  their  first  experience  with  the  in- 
juries, accidents,  and  diseases  incident  to  military  operations  in 
the  field,  since  the  introduction  of  anesthesia  and  the  improve- 
ment in  modern  war-implements.  Dr.  Agnew,  among  many 
others,  studied  his  cases  with  care  and  spent  many  hours  each 
day  in  the  wards. 

At  this  time  Dr.  Agnew's  great  kindness  of  heart  and 
simplicity  of  character  showed  themselves  most  strongly. 
Among  the  wounded  were  many  Confederate  soldiers,  far  from 
home,  among  a  people  something  more  than  strangers,  and 
utterly  penniless.  To  these  he  was  especially  tender,  and  aided 
many  materially  from  his  own  then  limited  means. 

The  Hestonville  Hospital  was  closed  in  April,  1863,  having 
been  open  nearly  a  year.  Dr.  Agnew  continuing  in  charge  until 
its  close.  Without  previous  experience  Dr.  Agnew  managed  the 
hospital,  from  the  beginning  to  the  end,  without  complaint  from 
the  government.  Much  of  the  routine  of  the  government  was 
complicated  at  the  beginning  of  the  war,  and  many  of  the  hos- 
pitals had  much  trouble  in  their  settlements;  but  there  never  was 
a  question  as  to  the  disposition  of  the  property  intrusted  to  him. 
The  trouble  was  usually  due  to  inexperience  in  the  preparation 
of  papers ;  Dr.  Agnew's  papers  were  always  correct. 

It  was  not  at  Mower  Hospital,  as  is  generally  supposed, 
but  at  Hestonville,  that  Dr.  Agnew  had  his  first  great  opportunity 


r.  ^'f^   .. 


Dr.  Agnew  in  1867. 


DR.    AGNEW'S    LIFE    FROM    1860    TO    1870.  133 

of  studying  gunshot  injuries;  liere  lie  liad  ample  time  and 
ample  material.  His  studious  lil'e,  his  previous  experience  as  a 
surgeon,  and  his  natural  aptitude  fully  equipped  him  to  deal 
with  every  emergency. 

On  the  closing  of  the  Hestonville  General  Hospital,  Dr. 
Agnew  was  too  busily  engaged  at  the  School  of  Anatomy  to  be 
transferred  elsewhere ;  but  in  the  fall  he  returned  to  ser\'ice, 
being  assigned  to  duty  at  the  Satterlee  General  Hospital,  where 
he  remained  several  months. 

The  Satterlee  General  Hospital  was  located  at  Forty-fourth 
and  Pine  Streets,  in  West  Pliiladelphia.  It  had  twenty-eight 
wards,  with  a  capacity  for  70  patients  in  each,  making  a  total 
capacity  of  nearly  2000  patients.  The  erection  of  this  hospital 
was  due  to  the  liberality  of  the  merchants  of  Philadelphia. 
Dr.  Isaac  Hayes,  the  celebrated  Arctic  explorer,  was  the 
Superintendent. 

After  the  Battle  of  Gettysburg  Dr.  Agnew  went  to  the 
battle-field,  and  performed  efficient  service  in  the  hospitals 
there.  Among  other  patients,  he  had  charge  of  the  case  of 
General  Winfield  S.  Hancock,  who  was  severely  wounded  during 
the  battle.  When  General  Hancock  was  candidate  for  the 
Presidency,  twenty  years  later,  it  made  a  strange  coincidence, 
for,  as  a  result,  Dr.  Agnew  had  charge,  in  his  life-time,  of  the 
cases  of  both  candidates  for  President  of  the  United  States  in 
1880  ;  both  being  under  his  care  for  the  same  kind  of  injury, — 
gunshot  wound. 

The  most  important  commission  held  by  Dr.  Agnew  during 
the  war  was  at  the  Mower  General  Hospital,  at  Chestnut  Hill, 
Philadelphia.  His  commission  here  was  dated  May  12,  ISG-I. 
This  was  followed  by  the  appointment  of  Dr.  Thomas  G.  Mor- 
ton to  a  similar  position,  June  25,  1861:. 

The  Mower  General  Hospital,  located  by  the  government 
at  Chestnut  Hill,  Philadelphia,  was  built  in  the  form  of  a  flat- 
tened ellipsoid,  the  length  of  its  main  corridor  being  one-half 
mile.     An  idea  of  its  size  and  capacity  can  be  gained  from  the 


134  LIFE    OF    D.    HATES   AGNEW,    M.D.,    LL.D. 

fact  that  twenty-seven  acres  were  inclosed  within  its  walls,  and 
the  circumference  of  its  grounds  was  just  one  mile.  The  ward 
buildings  ran  off  from  the  main  corridor  like  the  spokes  of  a 
wheel.  It  had  a  capacity  for  3600  people,  3100  of  these  being 
patients  and  500  attendants  and  guards.  Its  position  was  most 
fortunate ;  it  was  located  in  a  most  healthful  position,  on  an 
elevated  plateau,  four  hundred  feet  above  tide-water. 

It  was  arranged  that  each  consulting  surgeon  went  out  to 
the  hospital  on  alternate  days,  Sunday  being  omitted  except  in 
cases  of  emergency,  when  they  were  sent  for.  There  were  forty- 
eisfht  wards,  in  each  of  which  was  stationed  an  assistant  sur- 
geon.  Twenty-four  wards  were  assigned  to  Dr.  Agnew  and 
the  same  number  to  Dr.  Morton.  It  was  the  custom  of  the 
surgeons  to  reach  the  hospital  at  1  o'clock  and  remain  all  the 
afternoon,  first  going  through  each  ward  with  the  ward-surgeon, 
then  examining  all  cases  for  operation.  These  were  then  con- 
veyed to  the  very  commodious  operating-room. 

Only  the  minor  operations  were  performed  by  the  resident 
surgeons.  Emergency  operations  which  could  not  wait  for  the 
consulting  surgeons  were  performed  by  Dr.  Moon,  the  first 
assistant  under  Dr.  Hopkinson,  the  Superintendent. 

Although  the  hospital  had  been  built  to  accommodate 
only  3100  patients,  yet  it  was  frequently  so  crowded  that  over 
5000  cases  were  at  one  time  within  its  walls.  The  possibilities 
of  the  service  can  be  estimated  when  it  is  seen  that  this  number 
would  make  a  good-sized  town,  each  inhabitant  representing  an 
important  injury,  no  two  of  which  were  exactly  alike.  Each 
case  was  a  problem  in  itself,  and  the  task  of  caring  for  them 
was  a  terrific  undertaking. 

The  operations  performed  were  frequently  of  the  greatest 
magnitude,  such  as  ligations  of  the  principal  vessels,  as  the 
common  carotid,  the  femorals,  etc. ;  amputations  of  all  sorts, 
resections,  trephinings ;  extractions  of  balls  and  missiles  gen- 
erally. It  was  no  uncommon  occurrence  that  a  number  of  these 
major  operations  would  be  performed  on  the  same  afternoon. 


DR.    AGNEW'S    LIFE    FROM    1860    TO    1870.  135 

The  geographical  relation  of  Philadelphia  to  the  various 
points  of  contlict  made  it  one  of  the  most  convenient  points  to 
which  to  send  the  wounded  soldiers.  In  consequence,  the 
Philadelphia  surgeons  of  the  period  acquired  reputation  and 
experience  which  served  to  strengthen  their  position  as  being 
the  most  brilliant  and  successful  operators  in  America. 

When  the  war  was  ended,  in  1865,  Dr.  Agnew's  contract 
was  terminated  and  he  returned  once  more  to  the  quieter  rou- 
tine of  his  regular  professional  work. 

It  was  by  this  extensive  experience  during  the  war  that 
Dr.  Agnew  acquired  his  reputation  as  the  great  authority  in 
America  on  gunshot  wounds,  which  led  to  his  selection  as  con- 
sulting surgeon  in  the  Garfield  case. 

The  other  members  of  the  Agnew  family  were  not  idle 
during  the  period  of  the  Civil  War.  Professor  John  Holmes 
Agnew  published,  in  conjunction  with  J.  S.  Wright,  a  most 
elaborate  article  on  the  subject  of  the  Federal  Union,  entitled 
"  Citizenship  Sovereignty."  In  this  work,  reply  was  made  to 
the  arguments  brought  forward  that  the  government  had  no 
right,  by  the  power  of  the  Constitution,  to  prevent  the  Southern 
States  from  seceding,  and  that  slavery  was  a  divine  institution. 
The  amount  of  work  expended  on  this  little  volume  must  have 
been  tremendous.  Professor  Agnew  supplied  quotations  from 
Biblical  authorities,  Grotius,  Pufendorf,  Vattel,  Montesquieu, 
The  Federalist,  Madison's  Debates,  Curtis's  "  History  of  the 
Constitution,"  etc.,  in  order  to  strengthen  and  verify  the  state- 
ments made.     This  work  was  published  in  1863. 

At  the  same  time  the  Hon.  Daniel  Agnew,  at  that  period 
President  Jud^re  of  the  Seventeenth  Judicial  District  of  Penn- 
sylvania,  delivered  an  address  on  "  Our  National  Constitution : 
its  Adaptation  to  a  State  of  War  or  Insurrection."  In  this 
essay  he  presented  clear  views  of  the  change  wrought  by  war 
upon  this  frame-work  of  our  national  life,  and  the  dormant 
energies  it  starts  into  activity.  In  this  argument  he  proved 
that  the  Constitution  was  legally  enabled  to  act  in  such  an 


136  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

emergency  as  arose  at  the  beginning  of  the  late  Civil  War.  In 
eloquent  and  patriotic  terms,  he  proved  logically  and  fully  that 
the  government  had  the  right  to  levy  war  when  the  necessity 
arose. 

During  the  Civil  War  Dr.  Agnew  finally  severed  his  con- 
nection with  the  School  of  Anatomy,  and  received  his  first 
appointment  at  the  University  of  Pennsylvania.  For  some  time 
considerable  hostility  had  been  shown  to  the  School  of  Anatomy 
by  the  two  medical  schools  of  Philadelphia  on  account  of  its 
tremendous  size  and  reputation.  They  felt,  naturally,  that  their 
position  w^as  being  usurped.  By  this  move  the  breach  was 
happily  sealed. 

The  earliest  connection  of  Dr.  Agnew  with  the  University 
of  Pennsylvania  as  a  teacher  was  unofficial,  dating  back  as  far 
as  1858,  when,  at  the  solicitation  of  Dr.  Henry  H.  Smith,  then 
Professor  of  Surgery,  Dr.  Agnew  substituted  for  him  at  his  clin- 
iques,  in  the  course  of  regular  clinical  instruction.  He  contin- 
ued this  relation  with  Dr.  Smith,  frequently  acting  as  his  sub- 
stitute in  the  instruction  of  the  students,  until  December  21, 1863, 
when  he  received  his  first  official  appointment  to  the  University, 
being  made  Demonstrator  of  Anatomy  and  Assistant  Lecturer 
on  Clinical  Surgery.  This  latter  title  was  not  accorded  him, 
however,  in  the  catalogues  of  the  period.  He  succeeded  Dr. 
William  Hunt  as  Demonstrator  of  Anatomy. 

This  w^as  a  fortunate  move  on  the  part  of  the  University ; 
for  she  obtained  a  lecturer  who  had  proved  himself  the  best 
and  most  successful  teacher  of  the  period,  who  Avould  also  tend 
to  attract  to  her  lecture-halls  many  of  the  students  from  other 
schools,  who  had  been  studying  under  Dr.  Agnew's  care  at  the 
School  of  Anatomy.  This  is  a  potent  influence  in  medical 
instruction,  which  can  be  seen  in  any  medical  school ;  one 
man's  reputation  can  have  much  to  do  in  attracting  medical 
students.  Medical  students  are  very  much  given  to  the  worship 
of  some  ideal  teacher  or  operator,  and  frequently  go  long  dis- 
tances simply   to  study  under   a  certain  professor.     Being,   as 


DR.    AGNEW'S    LIFE    FROM    1860    TO    1870.  137 

a  class,  much  older  than  ordinary  collegiate  students,  and 
more  independent  as  to  their  movements,  they  are  able  to  do 
this. 

An  example  of  this  tendency  is  seen  in  the  autobiography 
of  that  eminent  surgeon,  Dr.  Samuel  D.  Gross.  He  stated,  in 
this  history  of  his  life,  that  he  left  his  preceptor  in  Easton  to 
enter  the  Medical  Department  of  the  University  of  Pennsyl- 
vania, having  in  his  pocket  letters  of  introduction  to  several  of 
the  professors ;  but,  visiting  the  clinique  of  Dr.  George  INlcClel- 
lan,  who  was  then  Professor  of  Surgery  at  the  recently  estab- 
lished Jefferson  Medical  College,  he  became  so  fascinated  with 
the  personality  of  tliis  distinguished  surgeon  that  he  gave  up 
at  once  all  thought  of  going  to  the  University. 

The  number  of  students  who  were  attracted  to  the  Uni- 
versity by  Dr.  Agnew's  reputation  can  never  be  estimated, 
of  course ;  but,  undoubtedly.  Dr.  Agnew  added  as  much  to 
her  financial  condition  as  he  did  to  her  moral  and  scientific 
side. 

Dr.  Agnew,  on  the  other  hand,  obtained,  in  his  demon- 
stratorship and  lecturership,  a  fair  position  in  the  University,  but 
not  one  at  all  commensurate  with  his  reputation  and  talents. 
He  was  not  made  a  member  of  the  Faculty,  although  his  posi- 
tion, of  course,  was  one  which  was  directly  in  the  line  of  pro- 
motion. The  appointment  to  the  position  of  Demonstrator  of 
Anatomy  at  the  University  of  Pennsylvania  rests  in  the  hands 
of  the  Professor  of  Anatomy ;  consequently,  Dr.  Agnew  owed 
this  position  to  the  courtesy  of  Dr.  Leidy.  As  Assistant  Lecturer 
on  Clinical  Surgery,  he  was  requested  to  assist  the  Professor  of 
Surgery  in  the  conduct  of  the  surgical  cliniques. 

The  composition  of  the  medical  faculty  at  this  time  was 

as  follows : — 

Emeritus  Professors. 

William  Gibson,  Professor  of  Surgeiy. 

George  B.  Wood,  Professor  of  the  Practice  of  Medicine. 

Samuel  Jackson,  Professor  of  the  Institutes  of  Medicine. 

Hugh  L.  Hodge,  Professor  of  Obstetrics  and  Diseases  of  Women  and  Children. 


138  LIFE    OF   D.    HAYES    AGNEW,    M.D.,    LL.D. 

Medical  Faculty  of  the  University  of  Pennsylvania  in  1863. 

Joseph  Carson,  Professor  of  Materia  Medica  and  Pharmacy. 
R.  E.  Rogers,  Professor  of  Chemistry. 
Joseph  Leidy,  Professor  of  Anatomy. 
Henry  H.  Smith,  Professor  of  Surgery. 

William  Pepper,  Professor  of  the  Theory  and  Practice  of  Medicine. 
Francis  -Gurney  Smith,  Professor  of  the  Institutes  of  Medicine. 
Richard  Alexander  F.  Penrose,   Professor  of  Obstetrics  and  Diseases  of 
Women  and  Children. 

On  the  appointment  of  Dr.  Agnew  as  Demonstrator  of 
Anatomy  there  was  the  commencement  of  the  extension  of 
clinical  teaching  at  the  University  again.  Just  as  before  his 
admission  as  a  student  in  1836  there  had  been  an  impetus  given 
to  clinical  teaching,  so  again  on  his  admission  as  teacher  at  the 
University  a  similar  impetus  was  imparted.  He  gave,  during  the 
winter  months,  a  course  of  lectures  on  "Regional  Anatomy,"  and 
a  course  on  "  Operative  Surgery  "  in  the  spring.  In  the  years  1865 
and  1866  he  gave  summer  instruction  for  students  at  the  Univer- 
sity, the  course  consisting  of  a  series  of  lectures  on  "Operative 
Surgery  and  Anatomy."  These  lectures  ran  through  the  spring 
and  summer  season,  beginning  in  March. 

For  the  next  seven  years  Dr.  Agnew  served  faithfully  the 
University  in  the  position  of  Demonstrator  of  Anatomy.  As  the 
years  rolled  by,  he  grew  to  be  more  valuable  as  an  acquisi- 
tion to  the  teaching  corps  of  the  University,  and  liis  general 
reputation  advanced  rapidly.  He  lectured  in  the  evening,  twice 
a  week,  from  7.30  to  8.30,  spending  the  remainder  of  the  even- 
ing in  the  dissecting-room  ;  but  he  was  there  frequently  also  on 
otlier  evenings.  The  duties  of  his  position  were  the  same  as 
those  which  he  had  administered  when  in  charge  of  the  School 
of  Anatomy.  He  experienced,  through  all  this  period,  a  great 
lack  of  supply  of  anatomical  material ;  tlie  Minutes  of  the 
Faculty  meetings  of  this  time  contain  several  pleas  from  him, 
urging  upon  the  Faculty  the  importance  of  their  taking  active 
measures  to  make  arrangements  by  which  the  supply  would  be 
made  more  certain  and  more  regular. 

After  seven  years   of  hard   service,  finally,  in   1870,  Dr. 


DR.    AGNEW'S    LIFE    FROM    1860    TO    1870.  139 

Agnew  intimated  his  intention  of  resigning  his  position  as 
Demonstrator  of  Anatomy  in  the  Medical  Department  of  the 
University.  This  intention  on  the  part  of  Dr.  Agnew  was 
deemed  of  sufficient  importance  for  the  calling  of  a  Faculty 
meeting.  As  a  result  of  the  conference  at  this  meeting,  at  a 
stated  meeting  of  the  Board  of  Trustees  held  March  1,  1870, 
Dr.  Agnew  was  nominated  for  the  Chair  of  Clinical  Surgery ; 
at  the  stated  meeting  held  April  5,  1870,  Dr.  Agnew  was 
elected  to  this  chair,  the  title  being  changed  to  tliat  of  "  Pro- 
fessor of  Clinical  and  Demonstrative  Surgery,"  the  term 
"  demonstrative  "  being  added  in  order  that  he  might  be  em- 
powered to  carry  out  fuller  instruction  in  demonstrative  sur- 
gery. This  chair  had  been  unoccupied  since  it  had  been  vacated 
by  Professor  Norris,  in  1857. 

At  the  request  of  the  Faculty,  the  Trustees  had  revived 
this  Chair  of  Clinical  Surgery,  which  had  formerly  been  held  by 
the  late  Dr.  George  AY,  Norris,  conferring  it  upon  Dr.  Agnew, 
who  thus  became  a  member  of  the  Faculty  of  Medicine  in  the 
University  of  Pennsylvania  at  the  age  of  52,  and  after  practising 
medicine  for  thirty-one  years.  The  student  who  expects  to  be 
a  professor  a  year  or  so  after  graduation  can  find  here  a  good 
lesson  in  patience. 

Dr.  Agnew,  in  being  made  Professor  of  Clinical  and  De- 
monstrative Surgery,  was  put  more  upon  an  equality  with  his 
fellow-teachers.  There  is  no  reason  why  he  should  not  have 
"been  given  this  position  on  his  first  connection  with  the  Univer- 
sity, excepting  the  flict  that  he  was  perfectly  contented  with  the 
demonstratorship ;  his  own  ambition  being  satisfied,  there  was 
no  one  to  suggest  his  further  advancement  to  the  professorship 
in  the  clinical  chair.  He  was  not  forcing  Dr.  Smith,  the  Pro- 
fessor of  Surgery,  from  his  lawful  position ;  on  the  contrary,  he 
was  aiding  that  chair  and  lightening  its  duties. 

The  history  of  clinical  instruction  at  the  University  is 
so  connected  with  the  history  of  this  chair  that  it  is  briefly 
quoted.      In    18-41    the    system    of    dispensary  cliniques    was 


140  LIFE   OF   D.    HAYES   AGNEV7,    M.D.,    LL.D. 

adopted  by  the  University ;  the  first  that  was  instituted  under 
its  auspices  was  conducted  by  Drs.  Gerhard  and  WilUam  P. 
Johnston,  in  the  building  of  the  Medical  Institute,  in  Locust 
Street  above  Eleventh.  It  was  there  carried  on  until  the  com- 
mencement of  the  course  of  1843,  when  it  was  transferred  to 
the  University  building  under  the  immediate  supervision  of  the 
professors,  with  the  assistance  of  these  gentlemen.  From  that 
time  to  the  present,  this  mode  of  practical  instruction  has  consti- 
tuted a  part  of  the  regular  course  of  medical  teaching  conducted 
by  the  University. 

In  connection  with  the  clinical  service,  two  rooms  within  the 
building  were  appropriated  for  the  accommodation  of  patients  re- 
quiring operations  who  could  not  be  immediately  removed.  By 
this  arrangement,  the  same  attention,  nursing,  and  care  was 
bestowed  upon  the  subjects  of  capital  operations  as  in  a  hospital. 

With  a  view  of  completing  the  plan  for  clinical  instruction 
so  as  to  give  it  the  greatest  efficiency  compatible  with  the  prog- 
ress of  medical  education,  it  was  resolved  in  1845,  by  the 
Faculty,  that  a  surgeon  connected  with  the  Pennsylvania  Hos- 
pital, and  whose  duties  there  were  performed  during  the  session 
of  the  University,  be  requested  to  officiate  as  clinical  lecturer  on 
surgery.  This  led  to  the  creation  of  a  Chair  of  Clinical  Surgery 
in  the  University,  by  the  Trustees,  and  the  appointment  by  the 
Board,  in  1847,  of  Dr.  Jacob  Randolph  to  perform  the  duties 
of  this  office  in  the  hospital.  In  1848  Dr.  Randolph  died,  and 
Dr.  George  W.  Norris,  who  had  delivered  the  course  of  clinical 
lectures  under  the  auspices  of  the  University  during  Dr.  Ran- 
dolph's illness,  was  elected  his  successor  in  the  professorship. 
Dr.  Norris  continued  to  perform  his  duties  as  Clinical  Professor 
until  1857,  when,  upon  being  elected  a  Trustee  of  the  Uni- 
versity, he  resigned. 

Dr.  Agnew  was  succeeded  by  Dr.  H.  Lenox  Hodge  as 
Demonstrator  of  Anatomy.  There  Avas  still  great  growth  in 
the  clinical  department,  chnical  lectures  being  delivered  daily 
throughout  the  year. 


DR.    AGNEW'S    LIFE    FROM    18G0    TO    1870.  141 

In  the  following-  year  Professor  Henry  II.  Smith,  not  being 
in  sympathy  with  the  expansion  of  clinical  teaching,  resigned 
the  Chair  of  Surgery,  and  Dr.  Agnew  was  chosen  his  successor, 
the  surgical  teaching  of  the  University  being  thus  again  united 
in  a  single  person.  The  chair  which  had  been  revived  to  serve 
as  a  medium  for  admission  of  Dr.  Agnew  to  the  Faculty  was 
abolished.  On  the  establishment  of  the  University  Hospital, 
in  1873-74,  Dr.  Agnew  was  made  Professor  of  Clinical  Sur- 
gery, still  retaining,  however,  his  didactic  chair,  and  the  late 
Dr.  John  Neill  was  associated  with  him  also  as  Professor  of 
Clinical  Surgery.  The  University  had  now  gone  to  AVest  Phila- 
delphia, and  this  fine  new  hospital  at  last  afforded  ample  clinical 
material.  On  the  endowment  of  the  Chair  of  Surgery  by  Mrs. 
Susan  R.  Barton,  widow  of  Dr.  Barton,  in  1878,  by  the  gift 
of  $50,000,  the  title  was  changed  to  that  of  the  "  John  Bhea 
Barton  Professorship  of  Surgery," — a  title  which  it  still  bears. 

Dr.  Agnew^  and  Dr.  Smith  had  long  been  as  Damon  and 
Pythias  to  each  other.  For  many  years  they  had  been  insepa- 
rable companions,  always  together  whenever  the  opportunity 
offered.  They  had  always  felt  the  greatest  love,  sympathy,  and 
admiration  for  each  other. 

For  many  years  they  remained  most  intimate  in  their  rela- 
tions; as  has  been  stated,  as  far  back  as  1858,  Dr.  Agnew  had 
been  in  the  habit  of  substituting  for  his  friend,  while  he  was 
Professor  of  Surgery;  and  still  earlier,  in  1854,  they  had  been 
associated  together  in  the  work  of  re-opening  the  Philadelphia 
Hospital  for  clinical  instruction.  When  Dr.  Smith  was  a  can- 
didate for  the  position  of  Professor  of  Surgery  at  the  University 
of  Pennsylvania,  in  1855,  Dr.  Agnew  was  one  of  his  most 
earnest  workers  and  supporters.  It  was,  probably,  somewhat 
through  Dr.  Smith's  solicitation  that  Dr.  Agnew  came  to  the 
University.  Unfortunately,  however,  Dr.  Agnew's  reputation 
grew  so  great  that  it  greatly  overshadowed  that  of  Dr.  Smith. 
This  was  not  the  fault  in  any  way  of  either.  It  was  simply 
the  inevitable  result  when  one  skillful,  famous  physician  comes 


142  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

unconsciously  and  slowly  into  competition  with  another.  Dr, 
Agnew's  progress  had  been  very  slow ;  he  had  not  forced  his- 
way  at  all ;  but,  coming  as  it  did,  simply  the  natural  growth 
and  demand  of  the  times,  it  was  resistless  even  to  Dr.  Agnew 
himself.  Dr.  Agnew  never  sought  the  position  of  Professor  of 
Surgery  in  the  slightest  way ;  never  by  word  or  deed  did  he 
intimate  that  he  wanted  it.  He  would  have  been  satisfied  for 
them  to  have  retained  their  old  relationship.  As  he  said  in 
his  farewell  speech,  at  his  last  didactic  lecture,  "  The  post  was- 
one  that  I  had  never  sought." 

The  opportunities  for  clinical  instruction  at  the  University 
Hospital  opened  the  way  for  the  appointment  of  a  Stafl"  of 
Demonstrators  of  Practical  Surgery  to  assist  Dr.  Agnew.  They 
were  :  Drs.  Hunter,  Willard,  Muhlenburg,  and  Elliott  Hichard- 
son.  Later,  the  Surgical  Dispensary's  staiF  was  increased,  Dr» 
Charles  T.  Hunter  being  made  Chief  His  assistants  were :  Drs. 
Stryker,  Muhlenburg,  Ashbridge,  Allison,  Willard,  Richardson, 
and  Porter. 

The  second  civil  hospital  with  which  Dr.  Agnew  was  con- 
nected was  the  Wills  Eye  Hospital.  He  applied  for  this  position 
in  order  to  round  out  his  surgical  experience. 

At  a  stated  meeting  of  the  Board  of  Managers  of  the 
Wills  Hospital  for  Diseases  of  the  Eye,  held  January  4,  1864, 
with  the  President,  Dr.  Paul,  in  the  chair,  the  Board  elected,  as 
attending  surgeons,  Drs.  A.  D.  Hall,  T.  G.  Morton,  Richard  J. 
Levis,  and  D.  Hayes  Agnew.  The  management  of  the  hospital 
was  arranged  in  such  a  way  that  it  required  the  annual  election 
of  its  medical  officers ;  therefore,  on  January  2,  1865,  Dr.  Agnew 
was  re-elected.  His  third  election  occurred  December  3,  1866. 
On  September  7, 1868,  Dr.  Agnew's  resignation  was  received  and 
accepted,  Dr.  Harlan  being  unanimously  elected  to  fill  his  posi- 
tion. On  October  5, 1868,  a  complimentary  Minute  was  adopted 
by  the  Board  of  Managers,  in  which  they  placed  on  record  their 
high  estimation  of  Dr.  Agnew's  professional  services  in  connec- 
tion with  that  institution.  He  was  made  Emeritus  Surgeon  to 
the  hospital,  reraainin'j  i^nrh  until  his  death. 


DR.    AGNEW'S    LIFE    FROM    1860    TO    1870.  14.^ 

As  there  is  a  complete  record  kept  at  the  Wills  Hospital 
of  the  major  operations  performed  by  the  different  surgeons,  it 
has  been  easy  to  complete  Dr.  Agnew's  record  of  eye-work 
during  his  term  of  service.  In  comparing  it  witli  the  work  of 
the  present  day,  it  must  be  remembered  that  the  accommodations^ 
of  the  hospital  have  grown  considerably  since  his  connection  with 
the  institution;  for  example,  in  the  month  of  January,  1864, 
there  were  only  38  new  patients  admitted  to  and  38  discharged 
from  the  house,  while  the  total  number  of  new  out-door  patients 
was  119.  The  number  runs  now  four  times  as  great  for  house 
patients,  while  out-door  patients  number  over  1000  monthly. 
In  addition,  Dr.  Agnew's  terms  of  service  were  principally  during 
the  summer  months  of  these  years,  affording  the  smallest  clien- 
tele; yet  he  performed,  during  this  short  period  of  time,  69 
operations  for  cataract,  15  iridectomies,  24  tenotomies,  5  divi- 
sions of  the  ciliary  muscle,  and  1  enucleation.  This  shows  that 
a  very  large  percentage  of  his  work  was  operative. 

Undoubtedly,  the  most  important  position  held  by  Dr. 
Agnew,  as  far  as  concerned  purely  operative  surgical  work,  was 
his  connection  with  the  Surgical  Staff  of  the  Pennsylvania  Hos- 
pital. This  institution,  from  its  location,  from  its  size,  and 
the  length  of  time  it  has  been  in  operation,  is  easily  the  first 
of  the  Philadelphia  hospitals,  and  its  staff  of  physicians  has 
always  consisted  of  the  leaders  of  the  profession  in  Philadelphia. 

Philadelphia,  one  of  the  largest  manufacturing  cities  in 
the  United  States,  is  the  scene,  daily,  of  countless  accidents. 
Her  busy  streets  also  teem  with  the  ordinary  dangers  of  city  life, 
and  the  extent  and  variety  of  her  population  afford  material 
for  the  study  of  diseases  of  every  kind.  It  is  opportunities  of 
this  sort  which  constitute  a  centre  for  medical  education.  These 
facilities  have  been  recognized  from  the  earliest  days  of  medical 
study  in  America.  The  Pennsylvania  Hospital  is  typical  of 
Philadelphia  ;  within  its  colonial  walls  the  greatest  variety  of 
acute  diseases,  accidents,  and  curious  medical  phases  of  Phila- 
delphians  have  been  found,  from  the  days  of  Gabriel  and  Evan- 


144  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

geline  down  to  the  present  time.  Its  quaint  buildings  and 
pleasant  grounds  caused  the  poet  Longfellow  to  end  here  the 
career  of  these  two  famed  lovers,  the  hero  and  heroine  of  the 
greatest  American  poem  ever  written. 

While  a  member  of  the  Surgical  Staff  of  this  hospital, 
Dr.  Agnew  was  given  a  practical  opportunity  to  demonstrate  the 
degree  of  fidelity  which  he  held  for  his  convictions.  The  circum- 
stances of  the  occurrence  are  as  follow  :  He  was  elected  a  mem- 
ber of  the  Staff  of  Attending  Surgeons  to  the  Pennsylvania 
Hospital  on  March  27,  1865,  serving  in  this  connection,  ac- 
ceptably, for  six  years.  On  May  29,  1871,  a  re&olution  was 
passed  by  the  Board  of  Managers  of  the  Pennsylvania  Hos- 
pital, requesting  the  staff  to  give  appropriate  clinical  instruction 
to  the  students  of  the  Women's  Medical  College.  This  question 
had  long  been  discussed  by  the  management  of  the  hospital, 
and  the  following  are  the  details  in  connection  with  it : — 

"  On  motion  of  Samuel  Mason,  the  following  resolution 
was  offered  at  the  meeting  of  the  Board  of  Managers  of  the 
Pennsylvania  Hospital : — 

"  The  Contributors,  at  tlieir  annual  meeting  in  fiftli  month,  1870, 
having  directed  that  appropriate  thorough  clinical  instruction  be  given 
to  the  students  of  the  Women's  Medical  College,  if  practicable,  at  the 
Pennsjdvania  Hospital,  and  having,  at  the  last  annual  meeting,  given 
reiterated  instructions  to  the  same  effect, 

"  Resolved^  That  it  is  hereb}'  made  tlie  dut^y  of  the  Medical  and  Sur- 
gical Staff  to  carry  into  effect  the  instructions  given  by  the  Contributors, 
as  above  mentioned,  during  their  term  of  office. 

"  Yeas  6,  and  Nays  5.  Those  who  voted  in  the  affirmative 
were:  John  Farnum,  William  Biddle,  Samuel  Mason,  Samuel 
Welsh,  Benjamin  H.  Shoemaker,  Mordecai  L.  Dawson.  Those 
voting  negatively  were :  Alexander  J.  Derbyshire,  Jacob  P. 
Jones,  Alexander  Biddle,  Joseph  B.  Townsend,  and  Joseph  C. 
Turnpenny." 

This  action  having  been  taken  by  tlie  Board,  they  received, 
at  the  same  meeting,  the  following  letter  from  Dr.  D.  Hayes 
Agnew : — 


DR.    AGNEW'S   LIFE   FROM    1860    TO    1870.  145 

1611  Chestnut  Street. 
Mr.  Jacob  P.  Jones. 

Dear  Friend:  Should  a  willingness  to  give  surgical  instruction  to 
female  students  be  required  as  a  condition  of  election  on  Monday,  I  de- 
sire that  you  will  do  me  the  favor  to  withdraw  my  name,  as  I  should 
regret  to  do  anything  which  would  embarrass  the  Board  in  carr3-ing  out 
the  wishes  of  the  Contributors. 

Very  truly  j'our  friend, 

D.  Hayes  Agnew. 

Immediately  upon  receiving  this  communication,  the  follow- 
mg  resolutions  were  passed  by  the  Board  of  Managers : — 

"  Whereas,  A  communication  has  this  day  been  received  from  Dr. 
D.  Haj^es  Agnew  declining  to  be  considered  a  candidate  for  re-election  if 
surgical  instruction  be  given  to  female  students,  in  accordance  with  the 
directions  of  the  Contributors  at  the  last  annual  meeting ;  and 

"  Whereas,  The  Board  feel  bound  to  carry  out  the  instructions 
of  the  Contributors ;  therefore, 

"  Resolved,  That  in  accepting  the  declination  of  Dr.  Agnew  the 
Board  desires  to  express  their  deep  sense  of  his  eminent  abilities  as  a 
surgeon,  as  well  as  the  faithful  manner  in  which  he  has  discharged  the 
arduous  duties  devolving  upon  him  while  connected  with  the  institution. 

"  Resolved,  That  a  copy  of  the  above  be  furnished  ,  Dr.  Agnew, 
signed  bj'  the  President  and  Secretary  on  our  behalf." 

Dr.  Agnew,  consequently,  was  not  a  member  of  the  Staff 
of  the  Pennsylvania  Hospital  for  the  next  six  years.  During 
this  period  he  devoted  such  time  and  energy  as  was  not  spent  in 
practice  on  his  work  in  connection  with  the  University  of  Penn- 
sylvania. On  the  7th  of  May,  1817,  however,  he  was  re-elected 
to  the  Staff  and  served  for  over  six  years,  resigning,  eventually, 
April  17,  1884. 

It  was  always  understood  by  Dr.  Agnew  and  his  friends 
that  his  re-election  to  the  Staff  of  the  Pennsylvania  Hospital 
meant  also  that  female  students  would  not  be  allowed  to  attend 
his  lectures,  as  that  was  the  ground  upon  which  he  had  resigned 
six  years  before,  and  as  he  still  retained  the  same  views.  It  has 
been  discovered,  however,  recently,  that  when  he  resumed  duties 
at  the  hospital  no  stipulation  in  regard  to  the  presence  or  absence 

10 


146  LIFE   OF    D.    HATES   AGNEW,    M.D.,    LL.D. 

of  female  students  was  put  upon  record  in  the  Minutes  of  the 
Board  of  Managers,  although  a  suggestion  was  made  in  the 
Board,  at  the  time  of  re-election,  that  women  should  not  be 
present  at  his  lectures,  or  should  be  asked  to  withdraw  if,  in 
the  judgment  of  the  lecturer,  an  operation  was  to  be  performed 
which  he  considered  unfit  for  their  presence.  Dr.  Agnew  re- 
signed on  the  very  day  that  the  resolution  was  passed  by  the 
Board  allowing  female  students  to  be  present  at  the  cliniques 
at  the  Pennsylvania  Hospital,  and  he  did  not  change  his  views 
in  later  years.  Consequently,  his  connection  with  the  Penn- 
sylvania Hospital  at  this  later  period  needs  explanation.  It  is 
undoubtedly  shown  in  the  following  letter  of  acceptance,  which 
is  copied  from  the  Minutes  of  the  meeting  of  the  Board  held 
May  28,  1877:— 

1611  Chestnut  Street. 
To  the  Board  of  Managers  of  the  Pennsylvania  Hospital. 

Gentlemen  :  I  am  deeply  touched  \)y  both  tlie  compliment  and  the 
confidence  implied  in  the  recent  action  of  your  Board  in  electing  me, 
"without  solicitation  on  my  part,  and  with  singular  unanimity,  as  one  of 
the  surgeons  to  the  institution  over  whose  interests  you  preside.  Though 
pressed  with  many  arduous  and  exacting  duties,  yet,  under  the  circum- 
stances, I  do  not  feel  at  liberty  to  decline,  and  shall,  therefore,  enter 
upon  the  duties  of  the  place  with  the  determination  to  serve  the  hospital 
to  the  best  of  my  ability. 

With  considerations  of  the  highest  respect,  I  am,  respectfully,  your 
obedient  servant,  D.  Hayes  Agnew. 

From  this  letter  it  cantbe  seen  that  Dr.  Agnew  was  re- 
elected without  solicitation  for  the  position  and  without  stipula- 
tion on  his  part,  and  that,  consequently,  he  took  it  for  granted 
that  the  Board  intended  to  remove  the  obstacle  which  had 
caused  his  separation  from  the  hospital  some  years  before.  He 
was  a  man  to  meet  such  an  action  half-way.  He  knew  that 
the  Board  could  not  have  been  led  to  believe  that  he  had 
changed  his  unalterable  determination  not  to  lecture  to  women 
students.  He  believed  that  they  had  come  over  to  his  views  in 
the  matter,  and  he  wisely  let  further  discussion  drop.     After 


DR.    AGNEW'S    LIFE    FROM    1860    TO    1870.  147 

consideration  of  these  circumstances,  it  can  be  seen  that  tlie 
Board  of  Managers  of  the  Pennsylvania  Hospital,  by  re-(^lecting 
him,  retreated  from  the  position  which  they  had  assumed  some 
years  before. 

After  his  election  there  were,  undoubtedly,  a  number  of 
female  students  who  attended  his  lectures,  but  he  interpreted 
their  presence  to  ignorance  of  his  views  on  the  subject;  and, 
moreover,  he  was  entirely  too  courteous  and  kindly  in  his  feel- 
ings toward  every  one  to  object  to  the  presence  of  the  women, 
— if  he  found  them  in  his  clinique-room, — even  if  tliey  over- 
whelmed him. 

In  order  to  see  whether  Dr.  Agnew's  belief  in  regard  to 
cliniques  in  which  male  and  female  students  were  admitted  was 
wrong,  it  is  necessary  to  know  of  what  a  clinique  consists  and  who 
the  students  are.  From  time  immemorial  it  has  been  customary, 
at  the  surgical  cliniques,  to  display  the  cases  of  venereal  diseases 
which  are  present  in  the  hospital,  and  study  them  carefully ; 
this  forms  a  part  of  the  regular  instruction  of  a  surgical  clinique. 
In  order  to  study  these  cases  thoroughly,  it  is  necessary,  of 
course,  to  enter  fully  into  the  minutest  details  of  the  diseases, — 
their  causes,  diagnosis,  and  their  treatment,  making,  at  the  same 
time,  the  necessary  exposure  of  the  patients.  The  utmost  free- 
dom of  speech  and  actions  is  required.  On  the  other  hand,  the 
audience  which  is  to  view  this  exhibition  is  not  composed  of 
physicians,  but  of  young  men  and  women  who  are  studying 
medicine. 

The  large  majority  of  such  students  who  attend  clini- 
cal lectures  at  such  an  institution  as  the  Pennsylvania  Hos- 
pital are  the  new-comers  at  the  medical  schools.  They  have  not 
become  fully  accustomed  yet  to  the  sights  and  work  to  which 
every  practising  physician  has  long  been  familiar.  There  can 
be  found  among  them  many  young  men  and  women  who  are 
not  of  mature  age, — some  of  the  students  being  frequently  as 
young  as  seventeen  or  eighteen  years  of  age.  Taking  such  a 
mixed  class  as  this,  containing  many  boys  and  girls  unaccus- 


l-iS  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

tomed  to  such  work,  and  exposing  to  them  the  unpleasant  sights 
and  facts  of  venereal  diseases,  is  a  task  from  which  a  modest- 
minded  physician  would  naturally  shrink. 

Dr.  Agnew  did  not  wish  to  deprive  the  female  students  of 
an  opportunity  to  study  these  diseases ;  simply  he  did  not  think 
that  the  "mixed  clinique  "  was  the  proper  place  for  them  to 
acquire  this  knowledge.  In  this  belief  Dr.  Agnew  did  not 
stand  at  all  alone.  A  great  number  among  his  friends  and 
colleagues  have  taken  the  same  ground. 

Dr.  Agnew's  belief  in  regard  to  female  medical  students  is 
a  corollary  of  his  ideas  on  the  subject  of  women  studying  medi- 
cine. Dr.  Agnew  was  not  opposed  to  the  higher  education  of 
women.  He  believed  that  the  ideal  place  for  woman  was  at 
home,  as  the  head  of  the  household,  but  he  realized  the  fact 
that  such  a  position  was  not  intended  for  all  women.  He  held 
the  sex  in  great  respect  and  consideration,  and  he  did  not  belittle 
their  powers  or  capacity  for  w^ork. 

Dr.  Agnew  did  not  oppose  the  admission  of  women  into 
the  medical  profession.  The  field  of  medicine  is  so  broad,  and 
there  is  so  much  room  for  minds  of  the  most  diverse  dispo- 
sitions and  talents,  that  he  realized  that  there  were  certain 
branches  of  medicine  to  which  they  were  peculiarly  adapted, 
such  as  the  preparation  and  mounting  of  microscopical  speci- 
mens, where  their  delicacy  of  touch  and  deftness  of  fingers 
made  them  well  adapted.  He  believed  that  their  minds  were 
sufficiently  powerful  for  them  to  grasp  the  amount  of  learning 
and  training  necessary  to  pass  successful  examinations ;  but  he 
had  a  deep,  insurmountable  disti-ust  in  the  ability  to  train  the 
special  talents  of  woman  into  the  attributes  of  the  really  suc- 
cessful practising  physician.  He  did  not  believe  that,  either 
naturally  or  by  their  centuries  of  inherited  training,  women 
made  good  practitioners.  In  a  similar  way  he  did  not  believe 
that  men  made  good  nurses,  no  matter  how  well  trained ;  and, 
if  he  could  avoid  it,  he  never  employed  a  male  nurse.  In  addi- 
tion, he  believed  that  the  environments  of  society  were  arranged 


DR.    AGNEW'S    LIFE    FROM    1860    TO    1870.  149 

in  such  a  way,  at  present,  that  a  woman  could  not  practise 
medicine  without  being  exposed  to  many  hardening,  unpleasant 
influences. 

At  the  same  time  Dr.  Agnew  recognized  the  futility  of 
opposing  the  admission  of  women  into  tlie  practice  of  medicine. 
If  the  State  would  allow  them  to  practise,  and  they  cared  to 
study  and  could  obtain  a  sufficient  number  of  patients  to  make 
the  practice  of  the  profession  profitable,  he  knew  enough  of  the 
world's  ways  to  realize  that  his  protest  would  be  unavailing ;  so 
that,  when  any  measure  came  up  in  which  he  felt  that  they 
would  be  successful,  he  did  not  attempt  to  defeat  them ;  for 
example,  at  the  time  of  the  last  agitation  of  the  question  of  the 
admission  of  women  to  the  Philadelphia  County  Medical  Society 
he  listened  courteously  to  the  statements  of  the  then-existing 
status  of  the  question  as  seen  by  the  women  physicians,  and 
expressed  his  entire  willingness  to  let  the  movement  take  its 
course,  saying  that  he  should  make  no  objections  to  the  admis- 
sion of  women,  should  the  Society  see  fit  so  to  vote.  When  it 
was  proposed  that  the  women  of  the  medical  profession  in  and 
around  Philadelphia  should  give  a  reception  to  Dr.  Hiram 
Corson,  Dr.  Agnew  allowed  his  name  to  go  on  the  joint  com- 
mittee of  medical  men  and  women  without  a  moment's  hesita- 
tion. 

Dr.  Agnew  served  at  the  Pennsylvania  Hospital,  after  his 
second  election,  until  April  17,  1884,  It  is  a  strange  coinci- 
dence that  he  served  as  a  surgeon  at  this  hospital  for  a  short 
time  over  six  years ;  he  was  out  of  office  six  years,  and  on  his 
return  to  service  he  remained  on  the  staff  again  for  six  years. 

Dr.  Agnew's  appointment  at  the  Orthopedic  Hospital  came 
next  in  point  of  time. 

Although  in  Europe,  by  the  year  1867,  there  were  a  few 
hospitals  devoted  to  the  science  of  orthopraxy,  yet  in  the  United 
States  there  existed  no  such  charter  institution  for  the  treatment 
of  bodily  deformities.  There  were,  of  course,  operations  per- 
formed for  club-foot,  etc.,  at  all  the  cliniqucs  of  the  large  hos- 


150  LIFE    OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

pitals,  but  the  after-treatment  of  adjusting  proper  apparatus,  the 
constant  manipulation  and  vigilance  necessary  to  prevent  recur- 
rence after  operation,  could  not  always  be  fully  carried  out,  due 
to  the  very  limited  accommodations  existing  in  general  hospitals 
for  this  purpose,  and  to  the  fact  that  few  hospitals  were  able  to 
defray  such  expense.  Thus  many  cases  of  club-feet  among 
poor  children  were  operated  upon  with  necessarily  ill  attention 
later.  Often  the  apparatus  was  left  off,  and  in  some  cases  the 
contractions  following  the  operations  produced  worse  deformi- 
ties than  the  original.  Drs.  Thomas  G.  Morton,  H.  Earnest 
Goodman,  S.  W.  Gross,  and  D.  Hayes  Agnew,  believing  that 
such  an  institution  had  long  been  needed  in  Philadelphia,  took 
up  the  movement  for  the  accomplishment  of  this  purpose.  In 
consequence,  these  four  gentlemen  met,  October  1,  1867,  to 
advise  as  to  the  best  means  for  a  hospital  for  deformities  in  this 
large  and  constantly  increasing  city. 

A  charter  had  been  prepared  and  a  second  meeting  was 
held  October  11,  1867,  and  Drs.  Agnew,  Morton,  Goodman,  and 
S.  W.  Gross  consented  to  act  as  a  board  of  surgeons,  with  Pro- 
fessors S.  D.  Gross  and  George  W.  Norris  as  consultants.  At 
this  meeting  a  committee  was  appointed  to  confer  with  those 
gentlemen  who  had  consented  to  serve  as  managers  of  the 
hospital.  On  October  23,  1867,  the  attending  surgeons,  with 
Dr.  S.  D.  Gross,  met  Edward  Hopper,  Dillwyn  Parrish,  and 
Joseph  C.  Turnpenny,  when  the  following  Minute  was  read 
and  adopted : — 

"  Whereas,  There  exist  in  all  large  communities  many  persons  suf- 
fering from  bodily  deformities,  such  as  hunchback,  h\\)  disease,  club-foot, 
knock-knees,  wryneck,  etc. ;  and 

"  Whereas,  A  large  proportion  of  such  persons  of  adult  age  seen  in 
our  streets  have  never  received  in  eavly  life  the  requisite  treatment  for 
such  deformities  ;  and 

"  Whereas,  Such  deformities  require  constant  care  and  attention  by 
operation  and  mechanical  appliances  for  greater  or  less  period  of  time  ;  and 

"  Whereas,  No  institution  now  exists  in  this  city  or  state  specially 
devoted  to  the  treatment  of  this  unfortunate  class,  and  believing  that 


DR.    AGNEW'S    LIFE    FROM    1860    TO    1870.  151 

many  persons  ma}-  be  saved  from  growing  up  deformed  and  a  burden  to 
Bociet}',  b>'  a  scientific  course  of  treatment  in  a  well-organized  Ortho- 
paedic Hospital,  we,  citizens  of  Philadelphia,  trusting  in  the  liberality 
of  the  public  for  support,  met  in  Parlor  No.  9  of  the  La  Pierre  House, 
on  Wednesday,  October  23,  at  5  o'clock  p.m.,  for  the  purpose  of  organ- 
izing an  Orthopaedic  Hospital  for  the  cure  of  such  deformed  persons  as 
hereinbefore  mentioned." 

Mr.  Edward  Hopper  was  appointed  temporary  chairman 
and  Dr.  Goodman  was  appointed  acting  secretary  of  the  Board. 

The  charter  prepared  by  the  medical  gentlemen  was  revised, 
and  while  waiting  its  approval,  which  took  place  by  "An  Act 
of  the  Court  of  Appeals"  in  December,  1867,  temporary  quar- 
ters were  opened  at  15  South  Ninth  Street,  over  the  surgical- 
instrument  establishment  of  Mr.  D.  W.  Kolbe,  who  had  been 
active  in  the  suggestion  for  its  establishment.  The  hospital 
was  opened  for  the  reception  of  patients  on  February  25,  1868. 
Only  out-patients  were  then  treated,  while  funds  \vere  being 
solicited  for  the  establishment  of  a  well-regulated  and  organized 
hospital. 

The  first  Board  of  Managers  appointed  imder  the  charter 
consisted  of  Edward  Hopper  (president),  J".  Gillingham  Fell, 
Charles  Macalester,  Samuel  S.  White,  Judge  William  S.  Pierce, 
Dillwyn  Parrish,  Joseph  C.  Turnpenny  (treasurer),  Charles  F. 
Norton,  James  B.  Nicholson,  J.  B.  McCreary,  Thomas  G.  Mor- 
ton, and  D.  Hayes  Agnew.^ 

Thus,  Dr.  Agnew  was  a  member  of  the  first  Board  of 
Managers,  and,  at  the  same  time,  served  as  surgeon  on  the 
Medical  Staff.  The  other  surgeons  were  Drs.  Thornas  G.  Mor- 
ton, H.  Earnest  Goodman,  and  S.  W.  Gross,  wdth  Drs.  S.  D. 
Gross  and  George  W.  Norris  as  consultants.  The  hospital  rap- 
idly increased  in  size  and  usefulness,  although  at  the  beginning 
of  the  second  year  only  four  beds  existed.  The  mission  of  the 
hospital  was  so  well  carried  out  that  only  $48  remained  in  the 

1  A  proup  photograph  of  these  gentlemen,  together  with  those  of  Prof.  S.  D.  Gross, 
George  W.  Norris,  M.D.,  and  S.  W.  Gross,  M.D.,  consultinn:  and  attending  surgeons,  and 
D.  W.  Kolbe,  now  hangs  iu  the  Board-room  of  the  new  hospital. 


152  LIFE    OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

treasury  at  this  time.  Each,  year  showed  an  increase  in  the 
number  of  patients  treated  and  operations  performed.  Drs. 
Morton  and  Goodman  did  the  largest  part  of  the  operative 
work,  while  Dr.  Agnew  held  the  position  of  influence  and  help 
rather  than  that  of  active  operator.  On  account  of  the  increase 
of  his  other  duties,  Dr.  Agnew  resigned  his  position  as  attend- 
ing surgeon  in  1871,  at  which  time  he  became  a  member  of  the 
Faculty  of  Medicine  at  the  University.  Since  that  time,  Dr. 
Agnew  held  the  position  of  consulting  surgeon  up  to  the  time 
of  his  death. 

In  the  fall  of  1870  a  department  for  nervous  diseases  was 
created,  to  which  were  elected  physicians  for  this  work.  It 
was  thousrht  advisable  to  treat  these  two  classes  of  disease  in  the 
same  institution,  because  of  the  relation  many  of  the  deformities 
bore  to  nervous  diseases,  and  as  many  cases  of  nervous  disease 
exacted  at  some  time  the  use  of  instruments  to  aid  in  locomotion. 

In  1872  the  hospital  removed  to  its  new  quarters,  where  it 
still  remains,  at  the  northwest  corner  of  Seventeenth  and  Sum- 
mer Streets.  The  other  consultants  with  Dr.  Agnew,  during 
this  period  of  service,  were  Drs.  Gross,  Norris,  Hunt,  More- 
house, and  Keen. 

From  the  founding  of  the  institution  up  to  November  30, 
1892,  there  have  been  11,560  surgical  cases  and  11,850  nervous 
cases  treated  at  the  daily  clinique,  with  3235  cases  that  have 
received  house  care,  making  a  grand  total  of  26,645  cases 
treated  since  its  foundation. 

Thus  it  was  that  he  grew  gradually  from  the  Master  of  the 
Anatomical  School  to  the  clear-voiced  professor,  the  clinical 
teacher  with  marvelous  hands,  and  the  trusted  surgeon  oF  enor- 
mous practice,  known  from  sea  to  sea,  from  the  lakes  to  the 
gulf,  as  the  last  great  appeal  in  practical  operative  surgery. 

The  professor  in  his  chair  had  become  a  marvel.  The 
most  eminent  members  of  his  profession  gave  public  testimony 
to  the  marvelous  clearness  of  his  statements,  the  sound  com- 
mon sense  of  his  teaching,  the  reliable  data  founded  upon  his 


DR.    AGNEW'S    LIFE   FROM    1860    TO    1870.  153 

own  operations  and  observations ;  the  large  forecasts,  wonder- 
fully suggestive  and  helpful,  which  lie  threw  out  before  benches 
of  eagerly  listening  students,  and  the  inspiration  to  faithful  work 
which  he  continually  breathed  into  those  who  hearkened  to 
him. 

He  became  the  consultant  of  consultants.  The  best  men 
of  his  noble  craft  felt  in  their  souls  that  Agnew  had  won  all 
that  he  knew,  and,  pouring  out  volumes  of  proof  for  what  he 
stated,  would  lead  them  ever  in  safe  paths. 

During  this  period  Dr.  Agnew  changed  his  residence.  He 
remained  on  Eleventh  Street  for  over  sixteen  years.  As  years 
rolled  by,  however,  the  centre  of  residences  had  moved  westward. 
Dr.  Agnew  finally  concluded  that  he  should  go  with  it.  Accord- 
ingly, in  1866,  he  purchased  the  house,  1611  Chestnut  Street, 
combining,  curiously,  the  figures  of  his  former  home, — 16  North 
11th  Street.  He  lived  in  this  house  for  nearly  twenty-one 
years, — until  the  fall  of  1886.  It  was  an  excellently  timed 
selection,  for  it  placed  him  again  in  the  centre  of  the  best 
section  of  the  city, — a  most  fortunate  thing  for  a  physician. 


CHAPTER  VII. 

Dr.  Agnew  as  Professor  of  Surgery. 

Dr.  Agnew's  appointment  as  Professor  of  Surgery  at  the 
University  of  Pennsylvania  was  made  May  2,  1871,  by  the 
Trustees.  He  began  now  to  carry  fully  into  effect  his  ideas 
on  the  teaching  of  surgery.  He  was  a  firm  believer  in  actual 
experience  and  observation  as  being  the  best  means  to  impress 
students  with  the  principles  and  practice  of  surgery.  He  in- 
creased the  size  and  scope  of  the  Surgical  Dispensary  and  added 
a  corps  of  Demonstrators  of  Surgery. 

The  University  of  Pennsylvania  had  decided  at  this  period  to 
change  its  location  to  some  such  position  which,  while  adapted 
fully  to  its  purpose,  would  be  permanent.  Consequently,  steps 
were  taken  to  settle  in  West  Philadelphia,  on  the  strip  of  land 
extending  south  from  Thirty-fourth  Street  and  Darby  Road. 

In  the  meantime  the  Medical  Department  left  their  quar- 
ters at  Ninth  and  Chestnut  Streets  in  the  spring  of  1873.  The 
winter  of  1873-74  was  spent  in  the  building,  252  South  Ninth 
Street,  formerly  occupied  by  the  Philadelphia  University  of 
Medicine  and  Surgery.     They  remained  here  until  June,  1874. 

The  first  course  in  the  new  quarters  in  West  Philadelphia 
began  October  12,  1874.  The  Hospital  which  had  been  erected 
was  inaugurated  by  Governor  Hartranft  in  1874  and  opened 
for  patients.  There  was  some  trouble  experienced  at  first  to 
place  the  officers  of  the  Medical  Department  and  those  of  the 
Hospital  on  a  satisfactory  footing.  This  was  finally  accom- 
plished by  making  the  professors  of  medicine,  surgery,  and 
obstetrics  ex-officio  officers  in  the  hospital  and  making  the 
professors  of  clinical  medicine,  surgery,  etc.,  members  of  the 
Faculty.  This  was  done  in  March,  1875.  On  March  6,  1874, 
Dr.  John  Neill  was  appointed  Associate  Clinical  Professor  of 
Surgery  by  the  Trustees. 
(154) 


DR.    AGNEW    AS   PROFESSOR    OF    SURGERY.  155 

Dr.  Ncill  retained  this  position,  for  several  years,  until  his 
election  to  tlie  position  of  Emeritus  Professor.  He  was  suc- 
ceeded by  Dr.  John  Ashhurst,  Jr.,  who  was  elected,  June  5, 
1877,  by  the  Trustees  to  the  position  of  Professor  of  Clinical 
Surgery.  Dr.  Ashhurst  retained  this  position  until  Dr.  Agnew 
retired  from  active  service,  in  1889,  when  he  was  advanced  to 
the  John  Rhea  Barton  Professorship  of  Surgery. 

During  this  period  of  the  reconstruction  of  the  Medical 
Department,  Dr.  Agnew  took  an  active  part.  He  bore,  to  a 
large  extent,  the  burden  of  the  responsibilities  of  the  financial 
questions  arising  from  the  increase  of  size  and  consequent 
expense.  The  Minutes  of  the  Faculty  meetings  of  this  period, 
meagre  as  they  are,  are  filled  witli  references  to  Dr.  Agnew's 
work  on  tliese  questions. 

The  organization  and  successful  formation  of  the  Dental 
Department  was  entered  into  by  Dr.  Agnevv'  with  great  interest. 
Some  influential  members  of  the  Faculty  strongly  opposed  such 
a  venture ;  it  is  interesting  to  note  that  Dr.  Agnew  was  a  mem- 
ber of  the  various  committees  appointed  to  overcome  these 
objections  and  remove  this  opposition.  The  successful  estab- 
lishment and  operation  of  this  department  since  1877  show 
the  soundness  of  this  judgment  of  its  suggesters  and  promoters. 

The  Faculty  meetings  were  held  the  third  Monday  in  each 
month,  at  the  homes  of  different  members.  Frequently  they 
were  held  at  Dr.  Agnew's  residence,  1611  Chestnut  Street. 

By  Dr.  Agnew's  suggestion,  orthopedic  and  venereal  dis- 
pensaries were  established  at  a  meeting  of  the  Faculty,  June 
29,  1877.  By  these  two  cliniques.  an  immense  amount  of  work 
has  been  done.  The  Spring  course  of  lectures  inaugurated  in 
1878  was  strongly  advocated  by  Dr.  Agnew,  and  to  him  was 
left  the  selection  of  a  number  of  its  lecturers. 

He  asked  during  this  time  that  some  remuneration  be  given 
his  demonstrators  of  surgery,  four  in  number.  In  consequence, 
the  sum  of  fifty  dollars  annually  to  eacli  was  voted  as  salary. 
Following  out  his  ideas  of  actual,  experience  in  teaching,  he 


156  LIFE    OF   D.    HATES    AGNEW,    M.D.,    LL.D. 

inaugurated  the  system  of  teaching  bandaging  and  fracture- 
dressing  to  first-course  students. 

Durmg  this  period  of  Dr.  Agnew's  connection  with  the 
Faculty,  there  was  a  very  wide  difference  of  opinion  between 
those  who. regarded  the  curriculum  as  the  best  possible,  and 
those  who,  on  the  other  hand,  thought  it,  on  principle,  the  worst 
possible,  and  only  redeemed  by  the  honesty  of  those  who  igno- 
rantly  employed  it. 

Dr.  Agnew  was  never  far  from  the  front  of  the  party  of 
progress,  and  he  did  much,  by  the  impression  of  his  earnest  con- 
victions, to  encourage  some  who  felt  their  spirits  fail  in  the 
apparent  hopelessness  of  the  conflict.  Apart  from  this  special 
question,  it  may  be  safely  asserted  that  in  the  Medical  Faculty 
there  was  no  one  whose  judgment  was  held  in  higher  esteem  by 
all  of  his  colleagues  ;  for  it  was  always  temperate,  deliberate,  and 
untainted  by  any  expression  of  selfish  interest. 

The  following  estimate  of  Dr.  Agnew's  services  in  the 
Faculty  of  Medicine  at  this  time  is  prepared  by  the  Provost  of 
the  University : — 

"  Dr.  Agnew's  powerful  personality  made  itself  felt,  in  the 
work  and  development  of  the  Medical  School  of  the  University 
of  Pennsylvania,  from  the  beginning  of  his  connection  with  it 
down  to  the  last  days  of  his  life.  His  great  success  as  a  teacher 
has  been  fully  referred  to  elsewhere  in  this  work.  I  remember 
well,  in  my  student  days,  the  admiration  and  devotion  which  we 
felt  for  him. 

"  When  he  was  added  to  the  Faculty  of  the  Medical 
School  it  was  felt  by  all  that  he  would  be  the  peer  of  the 
great  men  who  have  honored  the  chairs  they  held  in  that  school. 
This  expectation  was  more  than  realized.  He  grew  and  de- 
veloped steadily  year  by  year,  both  as  a  great  teacher  and  prac- 
titioner of  surgery.  It  is  not  for  me  to  allude  to  the  magnificent 
reputation  he  achieved  at  home  and  abroad,  or  to  the  great  work 
that  he  did  for  the  community  at  large,  and  for  surgical  science. 
I  am  more  especially  concerned  with  his  personal  relations  with 


DR.    AGNEW    AS    PROFESSOR    OF    SURGERY.  157 

the  Medical  Faculty,  and  with  his  influence  upon  the  progress 
and  growth  of  tlie  medical  scliool. 

"  He  was  admirahly  faithful  in  his  attendance  at  Faculty 
meetings,  and  showed  there  the  same  conscientious  care  in  the 
discharge  of  every  duty  that  marked  him  in  all  relations  of  life. 

"  The  last  fifteen  years  have  witnessed  a  complete  reorgan- 
ization of  the  Medical  School  of  the  University.  Large  interests 
were  concerned  and  there  were  honest  diffierences  of  opinion  as 
to  the  wisdom  and  safety  of  the  progressive  policy  pursued.  Dr. 
Agnew's  attitude  was  unswerving.  He  believed  in  honest, 
thorough  work  in  education  just  as  he  did  in  every  other  field 
of  effort.  Medical  teaching,  with  him,  was  a  sacred  trust.  Its 
duties  never  sat  lightly  upon  him.  He  welcomed  every  sub- 
stantial advance  in  the  interests  of  the  science  and  of  the  students, 
no  matter  at  what  increased  cost  of  personal  exertion.  Just  as 
we  know  his  open  and  impartial  mind  made  him  among  the 
first  to  welcome  the  great  truths  of  modern  antiseptic  surgery, 
so  he  accepted  with  equal  readiness  and  completeness,  as  soon  as 
convinced  of  their  soundness,  the  advanced  views  upon  inedical 
education. 

"  It  was  most  fortunate  that  in  Agnew,  Leidy,  and  Stille 
the  Medical  Faculty  contained  men  whose  names  and  characters 
were  towers  of  strength  during  these  years  of  struggle. 

"  Dr.  Agnew's  personal  relations  with  the  members  of  the 
Faculty  were  so  affectionate  ;  their  confidence  in  his  sincerity 
and  disinterestedness  and  genuine  sympathy  was  so  great  that 
his  advocacy  of  any  measure  went  far  to  secure  its  success.  His 
influence  in  tlie  councils  of  the  Faculty  was,  therefore,  powerful, 
conciliating,  and  elevating.  No  one  who  had  not  the  privilege 
of  frequent  personal  and  official  intercourse  with  him  can 
fully  appreciate  the  charm  which  his  character  and  consistent 
conduct  conferred  upon  such  relation. 

"  In  the  actual  work  of  the  Medical  School  his  services  and 
achievements  were  fully  as  conspicuous.  He  was  an  ideal 
teacher  of  surgery.     In  the  first  place,  he  kept  his  appointments 


158  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

with  his  class  with  scrupulous  fidelity.  At  a  time  when  every 
minute  of  his  day  was  of  golden  value  and  was  greedily  sought 
in  all  quarters,  he  would  travel  all  night  and  subject  himself 
to  every  fatigue  and  exposure,  or  would  unhesitatingly  sacrifice 
the  most  important  and  lucrative  consultations  rather  than  miss 
a  lecture  or  keep  a  class  waiting.  The  high  purpose  he  had  in 
teaching  impressed  every  student.  There  was  no  display  of  him- 
self, of  his  vast  attainments,  or  of  his  marvelous  skill.  He  said 
only  so  much  as  would  best  instruct  the  student,  and  he  did  only 
what  was  demanded  by  the  best  interest  of  the  patients  upon 
wliom  he  operated  before  the  class. 

"  He  taught  not  only  by  what  he  said  and  did,  but  by  what 
he  refrained  from  saying  or  doing.  I  am  sure  that,  during  his 
long  career  as  a  teacher,  not  one  word  was  uttered  nor  a  single 
operation  performed  which  was  hasty  or  ill-advised.  His  students 
depended  upon  his  teachings  with  that  fullness  of  confidence 
which  is  the  highest  tribute  to  any  teacher.  This  trust  in  him 
began  in  their  earliest  student  days,  and  it  continued  in  all  their 
subsequent  relations  with  him  after  they  had  entered  upon  the 
practice  of  their  profession.  He  did,  at  least,  as  much  as  any 
other  man  to  sustain  and  carry  forward  the  fame  and  success  of 
the  Medical  School  of  the  University  during  all  the  years  he  was 
connected  with  it. 

"  He  threw  himself  into  the  movement  for  the  establish- 
ment of  the  University  Hospital  with  characteristic  energy  and 
directness  of  purpose.  It  is,  indeed,  fitting  that  the  splendid 
portrait  of  this  great  master  in  surgery  should  adorn  the  hall- 
entrance  to  this  great  hospital  which  owes  so  much  to  him. 

"  His  best  thought,  his  valuable  time,  his  personal  exertions 
were  always  at  its  disposal.  In  the  advocacy  of  its  claims 
before  the  State  Legislature ;  in  personal  appeals  to  his  numer- 
ous friends  in  behalf  of  its  funds ;  in  generous  personal  gifts  to 
it  which  only  heralded  the  munificent  benefaction  announced  in 
his  last  testament,  he  displayed  a  love  and  solicitous  anxiety  for 
its  welfare  and  growth  which  were  of  incalculable  value. 


DR.    AGNEW   AS   PROFESSOR    OF    SURGERY.  159 

"  His  name  and  memory  will  forever  be  inseparably  asso- 
ciated with  the  Medical  School  and  the  Hospital  of  the  Uni- 
versity of  Pennsylvania,  and  they  will  be  cherished  there  as  a 
glorious  example  to  the  Faculties  and  students  of  all  coming 
times." 

In  1861  Dr.  Agnew  liad  been  given  the  honorary  degree 
of  A.M.  by  Princeton  College,  as  a  mark  of  appreciation  for  his 
work  in  advancing  the  position  of  surgical  science.  This  college, 
ever  friendly  to  him  and  his  ambitions,  conferred  on  him,  in 
1874,  the  honorary  degree  of  LL.D. 

In  the  summer  of  1872  Dr.  and  Mrs.  Agnew  went  abroad 
to  remain  a  few  months.  The  details  of  this  trip  are  given  in 
another  chapter.  They  were  accompanied  by  Dr.  Agnew's 
assistant.  Dr.  Charles  T.  Hunter.  Dr.  Hunter  was  regarded 
by  Dr.  and  Mrs.  Agnew  almost  in  the  light  of  a  son ;  he  stood 
easily  at  the  head  of  the  corps  of  assistants,  and  his  death,  in 
1884,  was  a  terrible  shock  and  irreparable  loss,  for,  not  only 
did  Dr.  Agnew  feel  that  he  had  lost  a  brilliant  assistant  and 
loving  companion,  who  was  bound  to  him  by  many  ties,  but  he 
realized  that  Dr.  Hunter's  place  could  never  be  filled  again  so 
ably  and  satisfactorily. 

During  this  time  Dr.  Agnew  continued  Ids  occasional  con- 
tributions to  medical  literature.  In  1865  was  published  his 
essay  on  "  Lacerations  of  the  Female  Perineum,"  in  which  he 
reported  a  new  operation  for  the  relief  of  this  condition,  devised 
by  himself  On  July  6,  1866,  he  began  the  series  of  papers  in 
the  Medical  and  Surgical  Reporter  on  "  Yesico-Vaginal  Fistula," 
which  was  subsequently  reprinted  in  pamphlet  form  in  1867.  In 
1882  he  combined  and  rewrote  these  two  essays  and  published 
them  in  book  form,  through  the  firm  of  Lindsay  &  Blakiston, 

This  book  stands  as  a  landmark  in  gynecology.  In  all 
good  historical  accounts  of  advance  in  this  branch  of  surgery  its 
force  and  advancing  influence  is  noted.  In  such  standard  works 
as  Mann's  "  System  of  Gynecology,"  the  proper  importance  of 
this  work  has  been  recognized. 


160  LIFE   OF    D.    HAYES   AGNEW,    M.D.,    LL.D. 

Dr.  Agnew  increased  at  this  time  his  fame  as  a  syphilog- 
rapher;  he  became  the  authority  in  America  on  this  division 
of  medical  worii. 

Dr.  Agnew  delivered  the  introductory  lecture,  October  10, 
1870,  to  the  incoming  class  at  the  Medical  School.  During  the 
period  1869-71  reports  of  his  clinical  work  were  published  in 
the  Medical  and  Surgical  Reporter,  by  Dr.  De  Forest  Willard. 
Dr.  Willard  collected  the  data  of  many  cliniques,  and  by  re- 
arrangement was  enabled  to  report  one  clinique  on  the  various 
phases  of  one  disease,  operation,  etc.,  making  the  cliniques  more 
valuable  than  when  published  as  delivered. 

The  number  of  papers  on  anatomy  in  its  relations  to  surgery 
and  medicine  reached  sixty  by  1864,  but,  as  has  been  stated 
before,  at  this  date  they  stopped  forever. 

He  delivered  an  address  to  the  Philadelphia  County  Medi- 
cal Society,  January  5,  1875,  when  retiring  from  its  presidency. 
He  took  as  his  subject,  "The  Results  of  a  Series  of  Experi- 
mental Observations  Connected  with  the  Repair  and  Develop- 
ment of  Bone-Tissue."  This  essay  was  afterward  incorporated 
in  his  work  on  surgery.  In  this  work  he  was  assisted  by  Drs. 
Charles  T.  Hunter,  Henry  C.  Chapman,  and  James  Tyson. 

In  1876  he  was  selected  to  deliver  the  "Address  on 
Surgery  "  before  the  Pennsylvania  State  Medical  Society.  Later, 
when  President  of  this  body,  he  delivered  an  address  on  "  Errors 
of  Diagnosis." 

During  this  period  the  great  literary  work  of  his  life  was 
begun,  "  The  Principles  and  Practice  of  Surgery,"  which  was 
issued  in  three  volumes.  The  first  volume  of  Dr.  Agnew's 
"Surgery"  was  published  in  1878,  the  second  volume  in  1881, 
and  the  third  in  1883.  The  mere  mechanical  labor  involved 
in  writing  this  work  was  tremendous.  There  were  over  1100 
pages  in  the  first  and  second  volumes,  and  nearly  800  in  the 
third,  making  a  total  of  3000  pages.  As  each  page  contains, 
on  an  average,  650  words,  this  makes  a  total  of  nearly  2,000,000 
words  for  the  entire  work. 


DR.    AGNEW    AS   PROFESSOR    OF    SURGERY.  161 

As  Dr.  Agnew  wrote  the  entire  book  with  his  own  pen, 
allowing  that  he  could  write  ten  words  a  minute,  whicli  was 
far  faster  than  he  worked,  for  he  was  constantly  compelled 
to  recall  cases  of  his  own,  to  consult  other  authorities,  and  do 
similar  work,  which  makes  the  progress  of  such  a  work  extremely 
slow,  it  would  take  3333  hours  of  constant  work  to  produce  it. 
Allowing  eight  hours  as  a  working  day,  this  would  keep  him 
occupied  steadily  for  417  days.  He  was  engaged  many  years 
upon  the  work,  doing  it  at  odd  times,  such  as  working  late  into 
the  night  and  getting  up  early  in  the  morning,  working  before 
his  early  breakfast.  The  tremendous  resources  of  his  vitality 
may  be  better  estimated  when  it  is  realized  that  this  work  was 
done  at  the  very  time  of  life'when  he  was  busiest  in  practice, 
busiest  at  the  University,  and  busiest  in  consultation  Avork.  The 
work  on  the  second  and  tliird  volumes  came  about  the  time  of 
the  Garfield  case,  which  added  to  his  already  tremendous  routine 
of  work.  The  number  of  illustrations  in  the  work  are  2198, 
each  one  of  them  being  selected  for  its  appropriateness,  and  the 
majority  of  them  being  original  to  the  work.  In  order  to  show 
the  tremendous  range  of  the  subjects  treated,  it  is  interesting  to 
note  that  the  index  of  the  three  volumes  occupy  seventy-three 
pages. 

The  opportunities  which  gave  Dr.  Agnew  the  ability  to 
write  this  work  are  unique  in  the  history  of  surgery.  It  has 
truthfully  been  said  that  never  again  can  such  a  work  on  the 
subject  of  surgery,  with  all  its  broad  ramifications,  be  produced 
from  one  man's  experience.  Dr.  Agnew  began  his  surgical 
work  before  the  introduction  of  anesthesia,  and  he  was  able  to 
keep  pace  with  the  advancement  of  surgery  in  all  directions. 
Such  an  opportunity  did  not  exist  before  his  time,  and  no  surgeon 
now  can  keep  in  touch  with  the  entire  subject  of  surgery,  for 
the  field  has  grown  too  vast.  In  this  ability  to  keep  in  touch 
with  the  entire  field  of  surgical  activity,  Dr.  Agnew  stands  in 
the  same  position    to   surgery  that  Dr.   Leidy  did  to  biology. 

No  worker  in  either  of  these  fields  can  ever  hope  to  occupy 


162  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

their  pre-eminent  positions.  "  Agnew's  Surgery  "  is  the  medi- 
cal diary  of  his  professional  life  for  fifty-one  years.  In  this 
work  he  has  recorded  his  own  views  upon  every  surgical  sub- 
ject, giving  the  history  of  countless  cases  of  his  own,  his  expe- 
riences, and  his  conclusions  upon  every  surgical  procedure. 

This  makes  the  work  invaluable  to  the  surgeon,  for  it  gives 
him  an  Agnew  perpetually  at  his  elbow.  A  busy  practitioner 
opening  its  pages  never  fails  to  find  clearly-drawn  lines  for  diag- 
nosis, useful  directions  for  treatment,  carefully-delineated  deduc- 
tions in  regard  to  operation,  and  positive  opinions  as  to  the 
arguments  for  and  against  operations;  for  Dr.  Agnew  knew  as 
well  when  not  to  operate  as  when  to  cut,  a  quality  not  possessed 
by  all  surgeons.  While  Dr.  Agnew  endeavored  to  express  his 
own  views  independently  on  all  subjects,  as  far  as  was  consistent 
with  the  scope  and  limits  of  the  work,  he  recorded  the  views 
of  other  writers,  that  difi"erent  plans  of  treatment  might  be  con- 
trasted. A  student  finds  in  its  pages,  also,  well-selected  notes  of 
medical  history  and  the  famous  and  curious  surgical  appliances 
of  former  days ;  but  through  the  whole  work  runs  the  distinct- 
ive thread  of  Agnew's  own  personal  experiences,  from  which  his 
thoughtful  and  practical  brain  had  gleaned  so  much.  Although 
he  never  obtrudes  himself  into  the  work,  yet  his  own  individu- 
ality stands  out  most  markedly.  It  is  written  in  much  the 
same  manner  as  he  lectured.  He  was  instinctively  a  teacher; 
when  he  theorized,  his  thoughts  at  once  carried  him  to  some 
practical  conclusion. 

During  the  last  few  years  of  his  life  the  spirit  of  extra- 
ordinary vitality  which  pervaded  every  department  of  medicine 
was  most  active  in  the  domain  of  surgery.  During  these  years 
Dr.  Agnew  was  not  an  idle  spectator,  but  he  carefully  watched 
all  that  occurred  within  the  region  of  his  special  study,  and, 
consequently,  he  felt  that  a  revised  edition  of  his  book  should 
be  published,  in  which  he  could  embody  whatever  new  things, 
by  observation  and  experience,  appeared  to  him  worthy  of  pro- 
fessional confidence.     Early  committed  to  the  parasitic  theory 


Fac-simile  of  Title-Page  of  Japanese  Edition  of 

Pk.    AgNKW's    "Si:i!GRIlY." 


DR.    AGNEW    AS    PROFESSOR    OF    SURGERY.  163 

of  disease,  and  adopting  methods  of  practice  in  harmony  with 
its  acceptance,  every  year  but  served  to  strengthen  liis  laith  in 
the  value  of  tlie  germicidal  agents  of  aseptic  and  antiseptic 
surgery.  He  realized  that  the  medical  statistician  must  begin 
anew  to  collect  and  formulate  surgical  data,  in  order  to  arrive 
at  conclusions  which  would  be  trustworthy  at  present.  Conse- 
quently, in  1889  he  revised  his  work  and  the  second  edition  was 
published.  He  was  surprised,  when  he  came  to  the  actual  work 
of  revision,  how  little  he  had  to  change  in  his  words  written 
before  the  introduction  of  antiseptic  surgery. 

After  his  death  the  publishers  of  the  work.  The  J.  B.  Lip- 
pincott  Co.,  feeling  that  there  was  a  necessity  again  for  its  re- 
vision, suggested  that  the  work  be  done.  As  the  ownership  of 
the  work  was  left  to  the  trustees  of  the  University,  they  dis- 
cussed this  matter,  but  at  the  wishes  of  Mrs.  Agnew,  who  felt 
that  this  monument  to  his  life-work  should  stand  as  he  had 
erected  it,  they  decided,  permanently,  that  it  should  go  down 
to  posterity  as  it  had  been  written  by  Dr.  Agnew,  being  the 
most  complete  and  exhaustive  description  of  one  man's  surgical 
experiences  in  the  history  of  the  world. 

In  1888  Dr.  Agnew's  "Surgery"  was  translated  into 
Japanese,  and  published  in  Tokio,  Japan.  The  fac-simile  of 
the  title-page  of  this  work  in  Japanese  is  given  on  the  opposite 
page ;  according  to  Japanese  customs,  it  is  at  the  back  of  the 
book.  The  translation  of  this  page  begins  at  the  upper  right- 
hand  corner  and  reads  downward,  the  Japanese  words  saying : 
"  The  American  edition  by  Dr.  D.  Hayes  Agnew.  Translator, 
the  Japanese  Doctor,  Masahito  Toyabe."  The  larger  marks  in 
the  central  column  are  the  title  of  the  book, — "  New  Treatise  on 
the  Principles  and  Practice  of  Surgery."  The  figure  at  the 
bottom  of  the  page  is  a  word  used  to  signify  the  first  volume  of 
a  set  of  two  or  three  volumes,  meaning,  literally,  "  top,"  as 
Japanese  books  are  piled  one  on  top  of  another,  instead  of 
being  placed  side  by  side.  The  left-hand  column  says :  ''  The 
original  was  published  in   1886,  the  translation  was  made  in 


164  LIFE   OF    D.    HAYES   AGNEW,    M.D.,    LL.D. 

1888";   or,  in  the  Japanese  method  of  writing  dates,  in  the 
twenty-first  year  of  the  reign  of  the  Mikado. 

On  the  second  page  of  the  booli  is  a  large  stamp  in  red, 
which  corresponds  to  the  American  copyright,  being  the  sanc- 
tion of  the  government  for  its  publication. 

The  book  begins  with  an  old  Japanese  motto  about  the 
value  of  scraping  bones,  eliminating  poisons,  removing  obstruc- 
tions, and  washing  uncleanness.  Then  the  translator  gives  his 
estimate  of  the  value  of  the  book  and  the  necessity  for  its  study 
by  Japanese  students.  Professor  Gross's  "  Surgery  "  and  this 
edition  are  the  two  great  standards  on  that  branch  in  Japanese 
medicine.  The  price  of  the  book  in  Japanese  is  $6,  which 
represents  in  American  money  about  the  value  of  $4.50.  This 
is  not  cheaper  in  comparison,  for  probably  not  more  than  one- 
tenth  of  the  work  has  been  translated. 

Theories  change,  new  doctrines  become  old,  and  most  medi- 
cal books,  even  the  most  successful,  have  a  life-time  which 
rarely  exceeds  in  duration  that  of  their  authors ;  but  it  is  safe 
to  say  that  surgical  writers  in  future  ages  will  still  turn  to 
"  Agnew's  Surgery  "  as  a  rich  store-house  of  clinical  facts  and 
personal  observations,  just  as  they  do  now  to  the  writings  of 
Pare  and  Chelius,  and  as  pathologists  do  to  the  works  of  Mor- 
gagni  or  Rokitanski. 

As  a  surgeon,  Dr.  Agnew  was  fearless,  yet  conservative ; 
not  shrinking  from  any  operation,  however  hazardous,  but  never 
eager  to  operate,  and  always  glad  if  he  could  see  a  way  to  cure 
the  patient  by  bloodless  methods.  His  honesty  and  candor  in 
this  matter  of  advising  operations  may  be  seen  by  his  recorded 
judgment  as  to  the  so-called  radical  cure  of  hernia.  It  is  well 
known  that  in  his  earlier  days  Dr.  Agnew  had  himself  devised 
an  operation  for  this  purpose, — one  of  the  most  ingenious  of  the 
many  ingenious  procedures  suggested  for  the  cure  of  this  in- 
curable affection, — and  that  this  operation  he  had  performed  in 
a  number  of  cases  with  excellent  immediate  results ;  had  he 
been  a  surgeon  less  judicious  in  conservativeness,  less  severe  in 


DR.    AGNEW    AS    PROFESSOR    OF    SURGERY.  165 

his  conscientiousness,  or  more  sanguine  in  his  prognostic  habits, 
he  would,  no  doubt,  have  continued  to  resort  to  it  to  Iiis  own 
manifest  pecuniary  advantage,  if  not  to  his  patients'  permanent 
benefit ;  but  experience  convinced  him  that  its  ultimate  results 
did  not  justify  its  dangers,  and  he  not  only  abandoned  it,  but 
publicly  declared  that  he  made  it  no  exception  in  professing  his 
profound  distrust  of  all  operations  of  this  character. 

In  no  phase  of  his  career  did  Dr.  Agnew  appear  in  a 
better  or  more  favorable  light  than  in  his  position  as  a  consultant. 
As  a  consulting  physician,  undoubtedly,  he  stood  as  a  model. 
He  happily  accomplished  the  ofttimes  difficult  task  of  being 
perfectly  loyal  to  the  doctor,  while  being  also  loyal  to  the  in- 
terests of  the  patient, — for  the  consulting  physician  occupies  a 
most  delicate  and  perilous  position  for  all  concerned.  This  po- 
sition is  rarely  realized  by  any  one  but  the  physician  who  has 
been  tried  in  such  a  capacity. 

Dr.  Agnew's  manner  was  perfection.  While  he  examined 
the  case  thoroughly,  quietly,  and  exhaustively  himself,  he  showed 
at  all  times  a  proper  deference  for  the  feelings  and  opinions  of 
the  physician  who  called  him  in.  He  never  attempted,  at  any 
time,  to  place  the  attending  physician  in  any  unfortunate  or  un- 
certain light.  If  he  felt  that  an  error  of  diagnosis  or  treatment 
had  been  made,  he  suggested  a  change  to  the  attending  physician 
in  such  an  adroit  and  pleasant  way  that  the  physician  himself 
frequently  felt  that  it  was  his  own  suggestion. 

Dr.  Agnew's  appearance  was  always  such  as  to  command 
respect.  Nearly  every  one  who  saw  him,  and  did  not  know 
him,  asked,  instinctively,  "  Who  is  that  man  1  "  He  had  the 
faculty  of  impressing  every  one  at  once  with  his  ability  and  con- 
scientiousness. Colonel  Rockwell,  the  intimate  friend  and  faith- 
ful nurse  of  President  Garfield,  said,  "  When  I  saw  Dr.  Agnew 
at  the  President's  bedside,  I  felt  instinctively  that  the  President 
was  in  the  hands  of  a  man  of  power  and  ability ;  Dr.  Agnew's 
personal  appearance  was  just  such  as  I  imagined  the  ideal 
surgeon  should  be." 


166  LIFE    OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

Dr.  Agnew  iii  his  lectures  used  no  notes ;  at  least,  never 
more  than  a  scrap  of  paper  with  the  heads  of  the  various  topics 
on  which  he  intended  to  speak  for  the  day.  He  lectured  as  a 
didactic  prolessor  three  times  a  week, — on  Tuesday,  Thursday, 
and  Friday.  On  Wednesday  at  12  o'clock  he  held  his  surgical 
clinique  at  the  University  Hospital,  where  he  displayed  and 
diagnosed  cases  and  operated.  By  long  training  he  was  able 
to  lecture  on  the  case  and  operate  at  the  same  time, — a  difficult 
achievement  to  learn,  for  it  requires  the  following  of  two  distinct 
lines  of  thought. 

As  an  operator.  Dr.  Agnew  was  skillful,  rapid,  and  success- 
ful. His  superiority  as  a  surgeon  could  be  seen  in  his  operating, 
even  by  the  merest  tyro,  unfamiliar  with  surgical  work.  Here  he 
showed  to  wliat  an  extent  a  naturally  adept  and  skillful  operator 
can  be  developed  by  a  long  training  and  experience.  He  worked 
with  the  utmost  rapidity,  confidence,  and  grace  at  all  times, 
and  yet  always  without  the  semblance  of  haste.  He  never  gave 
one  the  impression  that  he  was  hurrying,  although  he  showed 
that  he  was  keenly  alert  to  everything ;  when  he  was  in  the 
midst  of  an  operation  he  would  not  tolerate  the  slightest  in- 
attention, stupidity,  or  awkwardness  on  the  part  of  his  assistants. 
It  was  only  at  such  times  that  he  was  imperative  and  brusque 
in  his  manner ;  he  felt  that  the  safety  of  the  patient  demanded 
that  everything  be  sacrificed  for  his  or  her  case.  When  he 
picked  up  his  knife,  he  had  a  line  of  action  mapped  out ;  with- 
out a  flourish  or  a  sweep,  his  knife  sank  with  unerring  quickness 
to  the  exact  depth  he  intended,  and  as  quickly  was  withdrawn. 
There  was  no  undecided  dissections,  consultations,  wonderings, 
and  considerations  in  this  work. 

His  tall  and  erect  figure  was  always  the  first  object  which 
caught  the  eye  of  the  incomer  into  these  cliniques.  It  is  im- 
possible to  express  his  wonderful  tranquility  of  mind  and  confi- 
dence while  operating.  It  made  the  most  difficult  feats  in  sur- 
gery a  pleasant  task  to  witness,  for  he  never  imparted  any  sense 
of  uneasiness  to  spectators  or  friends. 


DR.    AGNEW    AS   PROFESSOR    OF    SURGERY.  167 

At  all  times  he  was  tliorouglily  collected  in  his  manner,  in 
the  midst  of  tlie  most  startling-  accidents  or  incidents.  Under 
the  most  dangerous  conditions  he  never  lost  his  head,  but 
quickly  and  quietly  adopted  the  best  method  of  action ;  for 
example,  one  writer  states  that  he  well  remembers  the  sudden 
rupture  of  an  axillary  vein  during  the  reduction  of  a  dislocation 
of  old  standing  at  the  shoulder-joint.  The  patient  instantly 
collapsed,  becoming  lifeless  in  appearance.  A  quiet  but  quick 
movement  of  the  hand  on  the  part  of  Dr.  Agnew  placed  his 
thumb  upon  the  subclavian  artery.  The  danger  of  death  from 
an  appalling  hemorrhage  was  averted,  and  the  patient's  life 
was  saved. 

Again,  in  an  operation  for  cancer  of  the  breast,  in  which, 
through  neglect,  the  disease  had  far  advanced,  the  glands  in  the 
axilla  being  deeply  involved,  all  at  once  there  was  terrific  hemor- 
rhage ;  Dr.  Agnew  quietly  said,  "  I  guess  we  had  better  clamp 
this,"  applying,  as  he  spoke,  a  clamp  over  the  seat  of  hemor- 
rhage. Then  he  resumed  the  operation  composedly ;  when  it 
was  finished,  he  said,  "Let  us  see  what  caused  this  bleeding." 
It  proved  to  be  due  to  a  rupture  in  the  axillary  vein,  owing  to 
invasion  of  the  cancerous  process  into  its  vicinity.  He  applied 
a  ligature  to  the  vein  and  dressed  the  wound,  not  in  the  least 
disconcerted  by  the  appearance  of  a  startling  accident  which 
would  have  unnerved  completely  many  surgeons.  Such  instances 
in  his  career  could  be  quoted  in  great  numbers. 

The  surgeon's  dexterity,  unfortunately,  is  like  the  work  of 
an  actor;  for,  while  it  delights  and  impresses  the  spectators,  it 
is  impossible  to  represent  it  adequately  to  posterity.  Dr.  Ag- 
new's  skillfulness  was  shown  as  much  in  little  operations  and 
in  small  matters  as  in  greater  ones ;  for  example,  the  way  in 
which  he  plunged  a  trocar  and  canula  into  a  hydrocele,  to 
draw  off"  the  fluid  contained  in  it,  would  frequently  create  en- 
thusiasm among  his  students.  As  this  little  operation  is  done 
without  the  use  of  anesthetics,  it  can  be  made  quite  painful 
if  done  unskillfully,  but  when  it  is  well  done  it  is  only  the  first 


168  LIFE   OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

shock  which  is  unpleasant.  The  lightning-like  rapidity  with 
which  Dr.  Agnew  would  perform  this  operation,  and  finish  it 
before  the  patient  was  fairly  conscious  of  what  had  happened, — 
although  it  is  the  custom  of  such  a  patient  to  watch  the  sur- 
geon's hands  most  anxiously, — was  most  pleasant  to  witness. 

His  recognition  of  surgical  conditions  was  remarkable,  and 
the  accuracy  of  his  diagnosis  was  seldom  questioned.  He  was 
the  recognized  counsel  of  last  resort, — the  chief-justice  of  the 
medical  supreme  court, — and,  whatever  difficulty  of  diagnosis 
arose,  a  decision  by  the  "  old  gentleman,"  as  he  was  affection- 
ately called,  was  always  decisive.  Often  in  examining  cases 
some  physician  would  say,  '' I tliink''  so  and  so.  Dr.  Agnew 
would  "invariably  say,  "/i5  ^s"so  and  so.  This  was  not  from 
any  egotism  on  his  part  or  self-assertiveness,  but  simply  the  re- 
sult of  his  training ;  his  logical  mind,  stored  with  the  knowl- 
edge of  so  many  years'  gathering,  could  grasp  at  once  a  case 
and  pronounce  upon  it  so  quickly  that  frequently  it  seemed 
almost  impossible  that  he  could  have  given  it  proper  con- 
sideration. 

An  incident  which  occurred  in  the  course  of  the  Garfield 
case  typifies  exactly  his  quickness  of  decision  and  action.  The 
physicians  in  consultation  upon  the  case  were  deciding  where 
the  lines  of  incision  should  be  made  to  liberate  the  pus.  Some 
said  one  place,  some  said  another.  Dr.  Agnew  was  the  only 
one  silent.  He  stood,  knife  in  hand,  waiting  their  decisions, 
for  he  was  to  do  the  operating.  The  coterie  of  physicians  turned 
to  him  and  asked  his  opinion.  Dr.  Agnew  said:  " This  is  where 
I  believe  the  incision  should  be  made."  As  he  said  the  words 
he  made  the  incision. 

There  was  one  result  of  Dr.  Agnew's  long  experience, — no 
matter  how  strange  a  case  appeared,  or  how  rare  a  thing  was 
seen  in  medicine,  he  was  able  always,  from  his  long  list  of  cases, 
to  compare  it  intelligently  and  comprehensively  with  similar 
cases  of  his  own.  This  made  him  a  most  fortunate  companion 
in  the  study  of  any  rare,  obscure,  or  interesting  case. 


DR.    AGNEW    AS   PROFESSOR    OF    SURGERY.  169 

He  was  an  example  of  punctuality;  when  one  had  an 
engagement  to  meet  him,  it  was  always  wiser  to  be  ten  minutes 
in  advance  of  the  appointment  than  two  minutes  late ;  yet  he 
was  never  in  a  hurry.  In  driving  with  him  through  many 
years,  no  one  ever  heard  him  use  a  more  vigorous  expression  to 
his  driver  than  "we  must  push  on." 

Dr.  Agnew,  as  has  been  said,  was,  in  the  true  sense  of  the 
term,  "ambidextrous," — not,  as  is  often  the  case  with  those  who 
claim  this  quality,  dividing  a  limited  modicum  of  skill  between 
two  hands  instead  of  concentrating  it  in  one,  so  that  they  might 
with  more  justice  be  called  "ambisinistrous,"  but  he  really  used 
his  left  hand  as  if  it  were  his  right,  taking  the  knife  in  either 
hand  indifferently,  and  often  himself  unconscious  which  he  was 
employing.  In  his  early  youth  he  had  injured  his  right  hand 
in  such  a  way  as  to  render  it  useless  for  all  practical  purposes, 
and  this  loss  of  the  use  of  the  right  hand  continued  so  long  that 
he  was  confirmed  thoroughly  in  the  practical  use  of  the  left  hand. 
Upon  the  restoration  of  his  right  hand  to  its  proper  condition 
its  dexterity  came  back  coupled  with  the  equally  free  use  of  his 
left  hand.  The  facility  with  which  he  used  either  hand  should 
serve  as  a  lesson  to  parents  to  instruct  children  in  the  free  use 
of  both  hands.  The  crippling  of  the  left  hand  is  a  relic  of  the 
Middle  Ages,  when  the  right  hand  held  the  sword  and  the  left 
the  shield,  and,  as  a  natural  sequence,  the  right  hand  was  tlie 
hand  of  good  faith,  while  the  left  was  the  reverse.  This  is 
crystallized  in  the  two  words  dexterity  and  si7iister. 

If  there  were  a  shade  of  preference  shown  by  Dr.  Agnew 
in  the  use  of  his  hands,  it  was  for  his  left.  Possibly  this  was 
in  order  to  preserve  the  balance  of  utility.  He  carried  his 
watch  on  the  right  side  of  his  waistcoat,  this  being  the  pocket 
which  his  left  hand  would  naturally  seek  with  his  arm  half- 
flexed,  A  person  who  gives  preference  to  the  right  hand 
instinctively  places  it  in  the  corresponding  pocket  on  the  oppo- 
site side.  It  has  been  claimed  that  this  is  not  a  fair  test  that  Dr. 
Agnew  preferred  his  left  hand  instinctively.     It  does  not  imply 


170  LIFE   OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

at  all,  however,  that  he  used  his  left  hand  when  ascertaining  the 
time  of  day,  for  watches  are  made  for  right-handed  people.  In 
his  use  of  the  scissors,  which  is  a  movement  very  difficult  to 
acquire,  he  was  indifferent  as  to  whicli  hand  he  used;  although, 
in  the  niajority  of  cases,  he  preferred  to  use  the  left  hand 
because  his  right  hand  might  happen  to  be  occupied  at  the 
time. 

It  is  generally  considered  an  excellent  test,  in  a  case  of 
acquired  ambidexterity,  for  determining  which  hand  is  given  the 
preference,  to  observe  wliich  hand  is  used  most  frequently  in 
writing.  Writing  with  the  left  hand  is  an  unnatural  procedure, 
as  the  thumb  and  fingers  that  hold  the  pen  hide  the  letters  that 
have  already  been  written,  while  with  the  right  hand  the  writing 
trails  away  from  the  already  written  word,  leaving  the  full  line 
visible.  Dr.  Agnew  almost  invariably  used  his  left  hand  in 
writing,  and,  strangely  enough,  wrote  with  the  back  of  his 
pen. 

Reade,  in  "  The  Coming  Man,"  mentions  the  wonderful 
accuracy  of  the  action  of  the  left-hand  fingers  in  the  case  of  a 
violinist,  whose  whole  skill  depends  not  so  much  upon  drawing 
the  bow  backward  and  forward  with  the  right  hand  as  it  does 
upon  that  wonderful  readiness  of  touch  that  enables  him,  auto- 
matically, to  select  the  string  and  to  place  his  finger,  with  such 
marvelous  accuracy,  upon  the  spot  which  will  develop  the  deli- 
cacy and  the  gradations  of  tone  that  are  required  to  make  music 
what  it  is  when  developed  by  the  touch  of  a  virtuoso. 

This  point,  raised  by  Reade,  was  seen  in  the  case  of  Dr. 
Agnew,  for  in  his  younger  days  he  developed  great  skill  in  the 
use  of  the  violin,  which  he  played  in  the  ordinary  manner  with 
the  bow  in  his  right  hand. 

This  fondness  of  Dr.  Agnew  for  the  use  of  his  left  hand 
was  seen  by  the  artist,  Mr.  Eakens,  when  he  was  painting  Dr. 
Agnew's  picture  for  the  University.  This  painting  represents 
Dr.  Agnew  at  the  completion  of  an  operation,  and  Mr.  Eakens, 
who  had  been  attending  his  cliniques  for  several  months  to  get 


DR.    AGNEW    AS   PROFESSOR    OF    SURGERY.  171 

his  charaGteristic  attitudes  and  methods  of  operating,  recognized 
at  once  this  peculiarity. 

This  slight  preference  of  Dr.  Agnew  for  his  left  hand  does 
not,  of  course,  detract  in  tlie  least  from  his  ambidexterity.  He 
could  do  equally  good  work  with  either  hand. 

In  all  kinds  of  surgical  work  Dr.  Agnew  was  equally 
happy.  He  was  just  as  capable  of  the  extremely  delicate 
work  of  extracting  a  cataract  as  he  was  in  the  expenditure  of 
force  necessary  for  refracturing  a  bone.  Skillful  in  all  oper- 
ations, he  was  especially  so  in  procedures  which  required  great 
delicacy  of  touch,  such  as  the  removal  of  thin-walled  cysts,  in 
which  his  long  habit  of  anatomical  dissection  came  particularly 
into  play. 

The  following  estimate  of  Dr.  Agnew's  services  as  a  sur- 
geon was  written  by  a  colleague  and  friend  of  thirty-five  years' 
standing,  and  his  successor  in  the  professorial  chair : — 

^  During  the  last  tw^enty  years  of  his  life  it  is  probable 
that  Dr.  Agnew  saw  more  patients  in  his  office  and  in  consul- 
tation than  have  ever  been  seen  by  any  other  Philadelphia  sur- 
e-eon. When  it  is  remembered  that  he  was  at  the  same  time 
constantly  engaged  in  teaching,  lecturing  regularly  during  the 
winter  months  four  or  five  times  every  week,  it  will  be  seen 
that  he  could  have  accomplished  this  amount  of  work  only  by 
carefully  allotting  his  time  and  by  being  blessed  with  an 
unusual  degree  of  physical  endurance,  enabling  him  to  disre- 
gard fatigue  by  which  another  man  would  have  been  completely 
exhausted.  Indeed,  it  was  for  years  Dr.  Agnew's  habit  to  take 
a  train,  after  a  full  day's  work,  in  order  to  see  a  distant  patient 
in  consultation,  making  his  visit  late  at  night  or  in  the  very 
early  morning,  returning  in  time  to  be  at  his  office  as  usual  the 
next  day  and  to  fulfill  his  lecture  engagements  at  the  University 
of  Pennsylvania. 

"  Possibly  the  best  way  to  form  an  estimate  of  the  position 
which  Dr.  Agnew  occupied  in  his  profession  is  to  consider  what 
would  have  been  the  state  of  affairs  had  his  personality  not 


172  LIFE  OF  D.    HAYES   AGNEW,   M.D.,   LL.D. 

existed;  who  can  say  what  American  surgery  would  have 
been  during  the  last  twenty  years  without  his  participation] 
Whether  advising  as  consulting  surgeon  at  the  bedside  of  a 
wounded  and  dying  President,  imparting  the  principles  of  his 
art  to  large  classes  of  attentive  and  eager  students  from  all 
parts  of  our  broad  country,  or  giving  the  benefit  of  his  great 
skill  to  the  humblest  clinique,  his  share  in  the  surgical  history 
of  his  time  was  such  a  large  one  that  it  is  hard  to  imagine  what 
that  surgical  history  would  have  been  without  it. 

"  Our  fair  city  has  had  ere  now,  in  her  professional  rank, 
great  operators,  such  as  Barton  and  Pancoast ;  great  writers  and 
teachers,  such  as  Gibson  and  Gross;  and  great  consultants, 
such  as  Physick  and  Norris,  who,  by  their  strong  personalities, 
established  the  tradition  of  surgical  practice  in  their  day  and 
generation ;  but  as  consultant,  teacher,  and  operator  combined, 
the  name  of  Agnew  will  long  be  spoken  of  as  that  of  the  height 
and  glory  of  Philadelphia  surgeons." 


CHAPTER  VIII. 

Dr.  Agnew's  Original  Work  in  Surgery. 

It  has  been  stated  that,  wliile  Dr.  Agnew  was  a  wonderful 
operator,  clear  teacher,  and  thorough  diagnostician,  he  had  no 
originality;  that  he  devised  no  new  instruments  or  operations, 
and  that  his  name  was  not  associated  with  any  great  original 
investigation  in  new  surgical  fields. 

There  is  no  more  necessity  of  a  surgeon  inventing  new 
instruments  or  new  operations  or  pursuing  original  investigations 
to  become  a  great  surgeon  than  there  is  in  a  great  lawyer  devis- 
ing new  legal  procedures,  or,  to  compare  it  with  an  occupation 
which  approaches  surgery  on  its  manual  side,  for  a  carpenter  to 
devise  new  tools  or  new  metliods  of  carpentry. 

It  is  the  faithful,  intelligent  way  in  which  he  uses  the 
knowledge  of  his  day  in  the  regular  routine  of  his  life  which 
constitutes  the  really  valuable  work  in  a  surgeon.  It  is  the 
fidelity  with  which  the  daily  grinding  application  to  work  is 
undertaken — on  which  it  is  impossible  to  dilate — that  forms 
the  real  basis  of  comparison  of  surgeons.  It  was  here  that 
Dr.  Agnew  stood  pre-eminent ;  yet  in  a  biography  of  his  career 
this  work  can  only  be  suggested.  There  is  no. way  to  show  its 
extent  without  wearying  the  reader.  The  description  of  the 
invention  of  some  trifling  instrument  or  operation  takes  more 
room  than  any  description  of  many  years'  work  of  this  character 
in  a  surgeon's  life. 

There  is  more  or  less  of  a  delusion  in  the  claim  of  any  origi- 
nality in  surgical  work,  for  it  is  a  gradual  growth,  to  which 
every  observer  adds  his  quota.  A  surgeon  may  develop  great 
pettiness  of  mind  and  spirit  in  devising  methods  or  instruments 
just  a  little  diff'erent  from  those  in  use  already  and  claiming 
them  as  inventions  of  his  own. 

Dr.  Agnew  disdained  such  w^ork ;  although  he  had  that 

(173) 


174  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

adaptability  of  making  anything  suit  his  purpose.  For  exam- 
ple :  After  showing  complicated  or  expensive  instruments  for 
certain  purposes,  at  his  lectures,  he  would  invariably  say :  "  But, 
gentlemen,  you  do  not  need  these  things,"  and  he  would  pro- 
ceed to  improvise,  out  of  simpler,  cheaper  instruments,  the 
necessary  articles. 

On  the  other  hand,  it  is  the  purpose  of  this  chapter  to 
show  to  some  extent  the  variety  of  instruments  and  operations 
devised  by  Dr.  Agnew,  and  some  reports  of  the  original  inves- 
tigations which  he  made.  It  must  not  be  understood  that  this 
list  comprises  the  entire  number  of  operations  or  instruments 
which  Dr.  Agnew  devised ;  it  is  simply  a  sample  of  this  work 
on  his  part.  All  those  who  are  interested  in  this  feature  of  his 
work  sufficiently  to  pursue  it  further  are  referred  to  his  treatise  on 
surgery.  The  description  of  his  own  work  in  his  "  Surgery  "  is  not 
complete.  His  well-known  modesty  impelled  him  instinctively 
to  place  himself  in  the  background,  and  he  does  not  claim,  by 
any  means,  all  that  is  his  due. 

Again,  Dr.  Agnew  never  blindly  followed  directions  in  any 
operation  nor  in  the  manufacture  of  instruments.  Dr.  Agnew 
probably  never  did  two  operations  exactly  alike;  he  modified 
every  operation  in  each  case  to  its  own  wants  and  needs.  He 
always  seemed  to  possess  a  great  reserve  fund  of  commonsense 
which  fitted  into  the  case  before  him  exactly.  He  treated  each 
case  simply  on  its  own  demands,  not  on  the  lines  laid  down  in 
text-books. 

Among  the  instruments  devised  by  Dr.  Agnew  was  his 
well-known  anterior  angular  splint  with  the  posterior  angular 
trough.  Dr.  Agnew  devised  this  simple  instrument  for  supra- 
condyloid  and  condyloid  fractures  at  the  elbow- joint, — difficult 
conditions  to  treat  properly. 

To  prevent  bleeding  in  case  of  wounds  of  the  chest 
from  rupture  of  the  intercostal  vessels.  Dr.  Agnew  devised  a 
needle,  strong,  sharply-curved,  with  a  blunt  point,  having  in 
it  an  eye  for  the  thread.     This  formed  a  very  efficient  instru- 


DR.    AGNEW'S   ORIGINAL    WORK    IN    SURGERY.  175 

ment  for  putting  a  ligature  around  the  rib  and  vessel.  He 
also  invented  another  ingenious  instrument  for  compressing  the 
wounded  intercostal  vessels.  This  instrument  consisted  of  two 
branches, — a  permanent  one,  having  a  little  mortice  on  its  con- 
cave surface,  into  the  middle  of  which  is  fitted  a  short  piece  of 
sea-tangle ;  the  other  branch  of  the  instrument  is  movable, 
and  can  be  run  up  and  down  on  the  shanks  by  turning  a 
handle.  The  object  of  the  little  piece  of  sea-tangle  set  into 
the  groove  on  the  inner  branch  of  the  instrument  is,  that  by  its 
swelling  it  may  compress  the  vessel  wliich  lies  below  the 
common  level  of  the  rib  in  the  costal  groove. 

Dr.  Agnew  also  devised  an  artery-forceps,  the  blades  of 
which  are  long  and  slender  and  armed  each  with  a  tooth, 
which  can  be  made  fast  by  a  button-slide. 

For  the  treatment  of  extra-capsular  fractures  of  the  hume- 
rus. Dr.  Agne^v  devised  an  internal  angular  splint,  and  a  cap  for 
the  shoulder  and  arm.  By  using  his  method  the  axillary  wedge- 
shaped  pad  of  Sir  Astley  Cooper  is  discarded. 

Dr.  Ao-new  also  contrived  a  rectal  chemise  for  use  in  dilata- 
tion  of  the  internal  and  external  sphincters,  in  operating  for 
hemorrhoids.  This  rectal  chemise  is  to  be  used  when  the  sur- 
face removed  is  too  extensive  to  be  stopped  from  bleeding  by 
the  ordinary  methods.  This  instrument,  like  others  devised  by 
Dr.  Agnew,  was  extremely  simple,  consisting  simply  of  the 
largest-sized  gum  catheter,  through  the  openings  at  the  end  of 
which  is  passed  a  stout  silk  thread.  Then  three  square  pieces 
of  ordinary  mosquito-netting  are  taken  and  placed  one  on  top 
of  the  other;  at  the  centre  of  these  squares  or  pieces  an  open- 
ing is  made  and  the  catheter  passed  through,  and  the  two  are' 
fastened  together  by  threads. 

Dr.  Agnew  uivented,  for  use  in  fracture  of  the  patella  or 
knee-cap,  a  simple,  ingenious,  and  efficient  splint,  which  takes 
the  place  of  more  elaborate  instruments.  It  is  the  most  common 
spluit  for  this  condition  in  use  at  present. 

For  the  removal  of  the  curious  deformity  of  webbed  fingers, 


176  LIFE    OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

Dr.  Agnew  originated  an  operation  which  removes  satisfactorily 
and  permanently  this  condition.  The  trouble  in  this  deformity 
has  been  to  prevent  its  recurrence;  by  ingeniously  dissecting 
flaps  and  stitching  them  together  Dr.  Agnew  obviated  this 
difficulty  entirely. 

Dr.  Agnew  devised  a  retractor  for  holding  aside  the  sac  of 
the  peritoneum  during  operation  upon  the  iliac  arteries.  This 
instrument  was  a  great  convenience  in  ligation  of  the  external 
iliac  artery.  Dr.  Agnew  also  devised  a  spiral  wire  probe  for  use 
when  the  sinuses  passing  down  to  diseased  bone  were  tortuous; 
from  its  flexibility  such  a  probe  could  follow  the  winding  track. 

Dr.  Agnew  also  invented  a  tlioracic  trocar  and  canula  for 
use  in  the  operation  of  thoracentesis.  This  instrument  consisted 
of  a  trocar  and  canula  with  a  stop-cock  and  a  gum  bag  or 
bottle,  having  a  nozzle  at  one  extremity  fitted  to  the  end  of  the 
canula  and  at  the  other  a  stop-cock  by  which  it  can  be  con- 
veniently emptied  and  filled.  By  use  of  this  instrument  the 
fluid  can  be  drawn  out  by  suction,  requiring  no  air-pump.  In 
the  absence  of  the  rubber  bag  a  bullock's  or  hog's  bladder  may 
be  employed  as  a  substitute.  In  this  Dr.  Agnew  shows  his 
adaptation  of  the  ordinary  implements  and  instruments  found  in 
the  average  country  household  to  surgical  use. 

Dr.  Agnew  originated  an  operation  for  the  treatment  of 
salivary  fistula.  This  annoying,  disfiguring,  and  obstinate  dis- 
ease resisted  all  operations  until  Dr.  x\gnew  devised  an  opera- 
tion which  was  simplicity  itself  It  consisted  in  depositing  a 
thread  between  the  duct  and  the  outside  of  the  cheek  with  its 
two  ends  brought  out  at  the  corner  of  the  mouth.  As  the 
threads  cut  their  way  out  by  ulceration  the  duct  is  detached 
from  the  external  opening  in  the  cheek. 

Dr.  Agnew  also  devised  an  operation  for  the  radical  cure 
of  hernia,  which  he  subsequently  discarded. 

Dr.  Agnew  also  modified  the  method  of  reduction  by 
manipulation  of  dislocations  of  the  arm  at  the  shoulder- 
joint.     Dr.  Agnew  devised  an  apparatus  for  hip-joint  disease 


DR.    AGNEW'S   ORIGINAL    WORK    IN    SURGERY.  177 

which  he  advises  for  use  under  certain  circumstances.  When, 
on  account  of  parental  obstinacy,  the  surgeon  is  sometimes 
compelled  to  compromise  by  adopting  a  splint  instead  of  follow- 
ing other  treatment,  such  as  rest  in  bed,  Dr.  Agnew  advised 
the  use  of  this  splint. 

Dr.  Agnew  also  modified  a  number  of  amputations ;  for 
example,  he  modified  the  flap  method  (or  the  musculo-tegu- 
mentary  method),  in  which,  by  an  ingenious  cutting  of  the 
flap,  he  was  enabled  to  make  the  skin  and  muscles  of  the  same 
length,  avoiding  the  deformity  which  results  from  the  retraction 
of  the  skin,  which  exists  to  a  much  greater  degree  than  that  of 
the  muscles. 

Dr.  Agnew  also  devised  a  method  for  reducing  paraphi- 
mosis, by  which  the  methods  in  common  practice  were  rendered 
unnecessary.  It  is  a  much  more  rational  plan.  Dr.  Agnew 
also  devised  a  blood-catheter,  which  serves  the  purpose  very 
well. 

Dr.  Agnew  also  devised  a  stone-forceps  for  use  in  lithotomy 
in  children.  Dr.  Agnew  also  contrived  a  pair  of  long,  rat-toothed 
forceps  for  use  in  the  operation  of  vesico-vaginal  fistula.  In 
gynecology  Dr.  Agnew  also  devised  a  mackerel-bill  ecraseur  for 
use  in  dividing  uterine  polypi.  Dr.  Agnew  also  devised  whale- 
bone bougies  of  certain  shapes  and  sizes. 

In  regard  to  the  statement  that  Dr.  Agnew  possessed  no 
specially  original  thoughts  in  surgery,  because  his  name  is  not 
associated  with  many  wonderful  advances,  this  was  due  partly 
to  the  fact  that  Dr.  xlgnew  held  human  life  too  dear  to  experi- 
ment on  it,  as  must  be  done  in  all  original  work,  and  partly  to 
the  fact  that  he  was  so  busily  engaged  that  he  did  not  have  time 
for  the  research  for  which  he  was  so  eminently  fitted.  At  the 
same  time,  no  small  amount  of  original  investigation  was  done 
by  him. 

In  strictly  surgical  and  pathological  work  stand  his  experi- 
ments made  to  establish  the  fact  of  the  transformation  of  the 
coagulum,  clot,  or  thrombus  into  an  organized  structure,  and 

12 


178  LIFE   OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

its  unification  with  the  walls  of  the  vessel, — in  other  words,  to 
determine  the  method  by  which  nature  arrests  hemorrhage.  In 
order  to  study  this  process  satisfactorily  he  had  a  number  of 
ligations  made  of  the  arteries  of  dogs,  by  Dr.  William  H. 
Mastin,  at  the  University  Hospital.  The  animals  were  killed 
at  different  periods  and  carefully  injected,  after  which  he  had  an 
opportunity  of  studying  each  specimen  as  it  was  prepared  by 
Dr.  E.  O.  Shakespeare. 

Dr.  Agnew's  practical  conclusions  are  quoted  from  the  work 
on  surgery,  vol.  i,  page  216,  as  follows : — 

"  When  a  ligature  is  placed  about  an  artery  and  firmly  tied, 
the  vessel  is  constricted  and  puckered  up  at  the  point  of  appli- 
cation. The  effect  of  such  constriction  is  to  divide  the  middle 
and  internal  coats,  which  become  both  incurved  and  retracted, 
the  external  or  fibrous  coat  remaining  unsevered.  The  blood 
thus  arrested  begins  to  coagulate  first  at  the  seat  of  ligation, 
where  it  occupies  the  entire  circumference  of  the  canal  of  the 
vessel.  To  this  coagulum  or  thrombus  are  added  successive 
layers  or  laminae,  and  as  the  column  rises  it  becomes  conical  in 
form,  reaching  up  to  the  first  collateral  branch,  and  either  not 
touching  the  walls  of  the  vessel  or  resting  only  against  one  of 
its  sides.  The  direction  of  these  successive  additions  or  laminae 
in  the  thrombus  is  transverse  or  slightly  oblique. 

"  If  a  portion  of  this  internal  thrombus  be  examined  at  any 
time  after  its  coagulation,  with  a  sufficient  power,  it  will  be  seen 
to  consist  of  a  vast  crowd  of  red  corpuscles,  with  here  and  there, 
indiscriminately  scattered,  a  few  white  ones,  and  all  supported 
in  the  fibrinous  frame-work  of  tlie  clot. 

"  Pressing  the  investigation  further,  let  a  section  of  the 
artery  and  its  clot  be  made  twenty-four  hours  after  ligature,  and 
a  wonderful  change  will  be  noticed  in  the  numerical  relation  of 
the  two  kinds  of  corpuscles.  Even  in  this  short  period  of  time 
the  red,  which  had  predominated  so  greatly,  have  begun  to  dis- 
appear, and  the  white  corpuscles  are  now  seen  thickly  scattered 


Dr.  Agnew  in  1876. 


DR.    AGNEW'S    ORIGINAL    WORK    IN    SURGERY.  179 

over  the  field.  If  successive  sections  of  this  clot  be  made  from 
the  base  towards  the  summit,  it  will  be  seen  that  the  white  cor- 
puscles diminish  in  numbers  from  below  upwards ;  that  is,  they 
are  most  numerous  in  the  oldest  part  of  the  clot.  The  secure 
manner  in  which  the  clot  or  thrombus  is  first  mechanically  con- 
nected with  the  enclosing  walls  of  the  vessel  is  here  worthy  of 
observation.  This  connection  is  threefold :  first,  by  being 
crowded  into  the  corrugations  made  by  the  puckering  of  the 
vessel  at  the  point  of  ligature ;  second,  by  moulding  its  surface 
into  the  plications  of  the  tunica  intima,  or  internal  coat ;  and 
last,  by  the  peculiar  behavior  of  this  coat,  which,  after  being 
severed  by  the  ligature,  splits  into  filaments  or  threads,  which 
float  into  the  midst  of  the  coagulating  blood,  and,  like  guys, 
serve  to  moor  the  clot  securely  into  place.  The  questions 
which,  at  this  stage  of  the  process,  demand  explanation,  are 
very  difficult  of  solution.  We  are  not  yet  in  a  position  to 
answer  them  with  any  certainty,  and  any  attempt  in  that  direc- 
tion brings  us  at  once  into  the  domain  of  conjecture.  These 
questions  are :  Where  do  these  crowds  of  white  corpuscles 
come  from  ]  and.  What  is  the  destiny  of  the  red  globules  ] 
"With  reference  to  the  first,  the  origin  of  the  white  bodies, 
several  explanations  may  be  advanced.  They  may  originate  by 
proliferation  from  the  few  which  naturally  belong  to  the  throm- 
bus, as  no  limit  can  be  fixed  to  the  rapidity  of  cell  multiplica- 
tion under  certain  stimulation ;  they  may  be  emigrants  wandering 
into  the  clot  from  the  vasa  vasorum,  according  to  the  views  of 
Recklinghausen  and  Bubnoff;  they  may  be  derived  from  the 
stable  cells  of  the  tunica  intima,  which  accords  with  the  opinions 
of  Romberg  and  Thiersch  ;  and  last,  and  least  probable,  they 
may  be  but  a  retrograde  metamorphosis  of  the  red  corpuscles, 
on  the  supposition  that  the  red  are  developed  from  the  white 
corpuscles.  I  cannot,  however,  help  believing  that  these  cells 
are  derived  from  three  sources :  first,  from  the  proliferating 
white  corpuscles  of  the  clot ;  second,  from  the  fixed  corpuscles 
of  the  endothelium ;  and  last,  from  the  emigrants  from  the  vasa 


180  LIFE    OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

vasorum.  It  is  quite  as  probable  that  the  endothelial  cells 
should  participate  in  the  work  of  repair  ;  in  other  words,  change 
from  a  passive  to  an  active  state,  as  that  tliose  of  connective 
tissue  should  do  so  under  the  disturbing-  influence  of  inflamma- 
tion. Those  experiments  which  show  the  presence  of  cells  in 
new  formations  bearing  granules  of  cinnabar  previously  injected 
into  the  blood  would  seem  to  establish  a  claim  for  emigration. 

"This  last  view  is  not  in  accord  with  that  of  Billroth,  who 
denies  to  the  stable  cells  of  the  intima  any  participation  in  the 
work  whatever,  attributing  multipUcation  of  white  corpuscles  to 
the  leucocytes  of  the  clot  and  to  wanderers  from  the  neighboring 
vessel,  coinciding  in  this  respect  with  the  statements  of  Reck- 
linghausen and  Bubnoff.  As  to  the  red  corpuscles,  they  very 
soon  become  decolorized  by  the  separation  of  crystals  of  hsema- 
toidin,  and,  it  is  supposed  by  some,  form  an  intercellular  sub- 
stance bv  unitins:  with  the  fibrin  of  the  thrombus.  If  the 
thrombus  be  examined  on  the  fifth  day,  another  notable  change 
will  be  seen.  Many  of  the  cells  have  become  spindle-shaped, 
one  step  in  the  direction  of  forming  connective  tissue ;  others 
have  sent  out  prolongations,  which,  joining  with  similar  proc- 
esses from  contiguous  cells,  form  together  a  net-work  with  very 
distinct  nuclei  at  the  points  of  contact  or  communication.  In 
this  system  of  inosculating  processes  we  have  the  provision  for 
the  vascularization  of  the  thrombus.  These  processes  become 
blood-channels,  and,  although  as  yet  containing  no  blood,  they 
are,  like  the  irrigating  canals  which  are  cut  in  various  directions 
through  some  arid  waste,  designed  to  receive  the  streams  which 
are  to  give  life  and  fruitage. 

"  While  these  changes  are  in  operation  within  the  throm- 
bus the  walls  of  the  vessel  are  by  no  means  passive.  An  active 
inflammatory  transudation  is  going  on,  infiltrating  its  tunics 
and  extending  even  into  the  loose  cellular  tissue  of  the  adven- 
titious coats.  It  is  this  which  rives  asunder  the  fibres,  lamellae, 
and  fasciculi  of  the  arterial  tunics,  and  admits  of  their  being  in- 
terpenetrated by  cell  organisms  or  leucocytes,  which  wander  out 


DR.    AGNEW'S    ORIGINAL    WORK    IN    SURGERY.  181 

of  the  nutrient  vessel,  and  which,  like  those  of  the  clot  within, 
assume  the  spindle  forms,  which  are  tlic  promise  of  the  future 
connective  tissue.  In  the  course  of  eight  days  the  work  fore- 
shadowed in  the  thromhus  of  five  days  is  well  advanced.  Many 
of  the  hlood-channels  are  completed  and  others  are  in  process 
of  completion,  the  processes  of  the  latter  connecting  with  the 
nuclei  on  the  walls  of  the  former ;  the  spindle  form  of  the  cells, 
both  of  the  clot  and  walls,  is  more  pronounced,  and  near  to  the 
intima  they  have  reached  the  stage  of  immature  connective 
tissue.  The  clot  is  beginning  to  shrink  from  loss  of  moisture  in 
the  intercellular  substance,  the  whole  becoming  more  compact. 

"In  all  these  changes  or  stages  of  transformation  it  would 
appear  that  the  constructive  force  develops  out  of  the  materials  of 
the  original  clot  an  organized  tissue,^that  is  to  say,  the  white 
cells  of  the  thrombus  retain  their  vitality  and  undergo  multipli- 
cation, passing  on  to  the  spindle  form ;  that  the  fibrin  which  deter- 
mines the  coagulation  is  not  substituted  by  something  else,  but 
transformed  into  intercellular  material,  the  fibrillation  of  which, 
with  the  spindle  cells,  constitutes  true  connective  tissue ;  and, 
finally,  that  from  other  cells  a  system  of  inosculating  canals  is 
constructed,  thus  forming  a  vascularized  structure.  Thus  far  we 
have  traced  the  leading  changes  in  the  clot  toward  organization. 

"We  have  seen  the  infiltration  of  the  tunics  of  the  vessel 
with  cell  forms  similar  to  those  in  the  coagulum,  and  their  inter- 
mingling at  the  tunica  intima,  obliterating  in  some  degree  their 
distinction  from  the  latter.  It  still  remains  to  establish  a  very 
important  vital  connection  between  the  two,  and  that  is  the 
connection  or  inosculation  of  blood-vessels.  The  thrombus  is  in 
possession  of  a  system  of  capillaries,  but  they  contain  no  blood ; 
and  the  next  step  is  to  form  such  a  union  with  the  vessel  of  the 
artery  as  will  establish  not  only  a  unity  of  blood-channels,  but 
also  a  oneness  of  circulation.  To  accomplish  this  it  would 
appear,  from  certain  preparations  recently  made  by  Dr.  Shake- 
speare illustrative  of  this  point,  and  which  I  had  the  oppor- 
tunity of  examining,   that   in    this   inosculation   between   the 


182  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

vessels  of  the  thrombus  and  those  of  the  walls  the  former  take 
the  initiative,  penetrating  the  tunica  intima,  first,  near  to  the 
point  where  the  artery  has  sustained  the  greatest  injury  by  the 
action  of  the  ligature." 

Dr.  Agnew  also  performed  a  number  of  experiments  to  de- 
termine the  process  by  which  callus  is  converted  into  true  bone. 
It  is  a  fair  sample  of  the  style  of  investigation  he  pursued : — 

"  The  development  of  the  organizable  material  of  the  callus 
into  true  bone  will  be  best  illustrated  by  introducing,  at  this 
point,  the  results  of  a  number  of  experiments  which  I  made 
upon  the  bones  of  chickens,  dogs,  and  guinea-pigs.  For  this 
purpose  numerous  fractures  were  produced,  and  dissections,  fol- 
lowed by  microscopic  examinations,  made  at  various  periods  from 
an  hour  and  a  half  after  the  injury  until  the  twenty-fifth  day. 

"  These  fractures  were  all  simple.  It  has  been  stated  that 
after  such  an  injury  the  blood  finds  its  way  into  the  medullary 
canal  between  the  fragments,  adheres  to  the  edges  of  the  peri- 
osteum when  torn,  and  permeates  the  muscular  and  the  con- 
nective tissue  next  to  the  bone.  This  describes  most  accurately 
the  appearance  presented  in  the  first  dissection  I  made  one  hour 
and  three-quarters  after  the  injury.  A  second  dissection  was 
made  three  days  later.  After  removing  the  skin  and  fascia,  the 
seat  of  damage  was  recognized  by  a  swelling  over  the  break,  of 
a  peculiar,  spindle-shaped  form.  Even  the  tendons  were  curi- 
ously spread  out  into  a  ribbon-like  expansion,  and  quite  adherent 
to  the  parts  underneath.  On  the  fifth  day  this  enlargement  is 
probably  at  its  height,  and  at  this  time  a  specimen  was  divided 
longitudinally,  for  the  purpose  of  study.  The  periosteum  was 
separated  for  over  half  an  inch  above  and  below  the  seat  of 
fracture.  At  the  latter  point  the  separation  was  greatest,  be- 
coming less  above  and  below ;  hence  the  spindle  form  of  the 
enlargement.  To  the  unaided  vision  the  same  material  which 
lay  beneath  the  membrane  was  also  external  to  it,  so  that  the 


DR.    AGNEW'S    ORIGINAL   WORK    IN    SURGERY.  183 

periosteum  was  in  reality  embedded  in  or  incorporated  with  it. 
It  was  also  seen  between  the  ends  of  the  bone  when  not  dis- 
placed, or  between  the  contiguous  surfaces  when  overlapping, 
and,  finally,  for  some  distance  up  and  down  the  medullary  canal. 
This  preliminary  formation  was  a  light-colored,  consistent  sub- 
stance, interspersed  with  dark-red  spots,  and  gave  to  the  fracture 
a  considerable  degree  of  fixation. 

"  This  specimen  was  placed,  for  microscopic  preparation, 
in  charge  of  Dr.  Rhoads,  who  furnished  me  with  an  opportunity 
to  study  each  section,  in  order  that  the  appearances  might  be 
more  vividly  impressed  upon  my  mind.  The  material  in  con- 
tact with  the  fracture  was  found  to  consist  of  blood-corpuscles 
in  various  stages  of  disintegration,  some  adhering  in  rolls  and 
preserving,  in  some  degree,  their  form,  some  isolated,  others  col- 
lapsed, with  irregular  or  stellated  margins,  homogeneous  lymph, 
and  great  numbers  of  the  so-called  germinal  corpuscles,  or,  in 
the  light  of  more  recent  discovery,  leucocytes.  These  compo- 
nents were  irregularly  intermixed,  and  here  and  there  stained 
with  what  seemed  to  be  the  coloring  matter  of  broken-down 
blood-corpuscles.  The  leucocytes  varied  much  in  form  ;  some 
were  round,  others  oval.  They  varied  also  in  size,  as  though 
under  the  active  process  of  change. 

".  In  the  compact  portion  of  the  bone  a  noticeable  contrast 
existed  between  the  Haversian  canals  near  the  fractured  ends 
and  those  more  remote.  The  size  of  the  former  was  much 
greater,  and  tliey  presented  at  numerous  points  little  recesses  or 
loculi  leading  off  from  their  sides.  The  blood-vessels  could  be 
distinctly  seen,  but  they  were  pushed  off  from  the  sides  of  their 
bony  canals,  the  intermediate  space  being  occupied  by  crowds 
of  cells  in  all  respects  like  those  exterior  to  the  bone,  and  whicli 
came,  no  doubt,  from  the  Haversian  vessels.  Now,  as  the 
Haversian  canals  open  into  the  medullary  space,  and  also  upon 
the  broken  surfaces  of  the  bone,  the  conclusion  was  inevitable 
that  many  of  the  cell-bodies  seen  in  the  medullary  canal  came 
from  these  sources,  as  well  as  from  the  vessels  of  the  medullary 


184  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

membrane.  In  this  rapid  enlargement  of  the  hard  bony  canals 
traversed  by  the  blood-vessels  we  have  an  example  of  one  of 
those  singular  changes  which  attend  inflammation,  and  which 
it  is  difficult  to  explain.  That  it  is  due  to  absorption  from  the 
pressure  exerted  by  the  exudation  is  exceedingly  improbable,  as 
such  pressure  would  destroy  the  contained  vessels  rather  than 
affect  the  bony  walls  with  which  they  are  surrounded. 

"  In  studying  the  inflammatory  process  in  other  tissues,  an 
analogous  phenomenon  may  be  witnessed.  In  cartilage,  for 
example,  the  normal  corpuscles  which  lie  embedded  in  the 
intermediate  substance  have  their  places  occupied  by  a  multi- 
tude of  leucocytes,  more  changeable  and  active  than  those 
which  they  have  replaced,  and  whose  insatiate  demand  for  pab- 
ulum compels  them  to  prey  upon  the  matrix,  the  consumption 
of  which  gives  the  structure  an  open,  reticulated,  or  honey- 
combed appearance.  It  is  quite  probable,  therefore,  that  the 
organic  constituents  of  bone  may  be  attacked  by  the  migrated 
cells  of  its  vessels,  and,  thus  separated  from  the  bone-salts,  give 
rise  to  the  enlarged  canals  and  their  irregularities.  The  phe- 
nomena presented  in  this  first  specimen  appear,  then,  to  have 
been  those  of  an  inflammatory  character,  in  which  all  parts  of 
the  bone  at  and  contiguous  to  the  fracture  were  engaged.  The 
periosteum  incorporated  with  the  reconstructive  material  in 
seven  or  eight  days  entirely  disappeared  as  such,  undergoing 
those  changes  which  inflammation  produces  in  ordinary  connect- 
ive tissue,  while  a  new  membrane  was  produced  external  to  the 
spindle-shaped  mass  of  new  matter  and  continuous  with  the  old 
periosteum  at  the  limits  of  the  separation. 

"  A  second  specimen,  nine  days  old,  was  subjected  to  a 
similar  examination.  In  this  fracture  the  periosteum  had  not 
been  entirely  broken,  and  consequently  there  was  no  displace- 
ment of  the  fragments.  It  was  divided  longitudinally.  The 
periosteum  was  not  torn  from  the  bone,  but  was  separated  by 
the  exudation  for  about  one  inch  above  and  below,  in  the  same 
fusiform  or  spindle-like  manner  as  in  the  specimen  first  studied, 


DR.    AGNEW'S    ORIGINAL    WORK    IN    SURGERY.  185 

only  to  a  greater  degree.  The  reconstructive  material  lay  be- 
tween the  bone  and  the  periosteum,  external  to  the  latter,  be- 
tween the  ends  of  the  fracture  in  small  amount,  and  within  the 
medullary  canal.  This  does  not  accord  with  Mr.  Stanley's 
statement,  who  alleges  that  when  thus  apposed,  and  without 
disturbance,  no  provisional  callus  is  supplied  by  nature,  but  that 
immediate  union  takes  place, — an  opinion  in  which,  I  believe, 
Mr.  Paget  concurs.  The  stage  of  organization  was  not  alike 
in  all  portions  of  the  new  material.  The  development  was 
evidently  advancing  from  without  inwards.  The  greater  part 
of  this  new  formation  consisted  of  round,  oval,  and  elongated 
masses  of  germinal  matter,  surrounded  by  a  faintly  granular 
and  fibrillated  intercellular  or  formed  material. 

"  These  cells  were  grouped  irregularly,  or  arranged  in 
an  orderly  manner  in  concentric  ranks,  corresponding  to  the 
canals  seen  a  little  later  and  foreshadowing  the  laminae  of  the 
Haversian  systems.  The  cells  which  lay  between  the  ends  of 
the  bone  and  in  the  medullary  canal  were  more  numerous  and 
less  distinctly  altered  from  the  globular  form,  and  were  greatly 
in  excess  of  the  intercellular  or  formed  material ;  this  latter 
was  still  mingled  with  a  little  broken-down  blood.  In  the 
angles  between  the  periosteum  and  the  bone,  and  in  an  oval 
space  near  the  centre  of  the  external  or  ensheathing  matter,  the 
transformation  into  soft  bone  had  taken  place  by  the  deposit  of 
bone-salts.  In  these  situations  the  Haversian  canals  were  large 
and  numerous,  running,  some  diagonally,  others  perpendicu- 
larly, between  the  periosteum  and  the  old  bone.  Simultaneous 
with  the  calcareous  conversion  of  the  intercellular  material  were 
the  formation  of  the  canaliculi  and  the  shaping  of  the  previously- 
arranged  cells  into  distinct  lacunae. 

"  In  the  spindle-shaped  envelope  or  ferrule  we  have  the 
ensheathing  callus  of  Dupuytren,  or  what  he  termed  'provisional 
callus,'  while  the  portion  occupying  the  canal  answers  to  the 
pin.  These,  according  to  this  distinguished  surgeon,  were  only 
temporary  in  their  duration, — splints,  in  other  words,  to  main- 


186  LIFE    OF    D.    HAYES   AGNEW,    M.D.,    LL.D. 

tain  a  degree  of  connection  until  a  secondary  deposit  took  place 
between  the  ends  of  the  bone,  after  which  the  former  were  re- 
moved, being  no  longer  of  use. 

"Other  specimens  were  examined  on  the  thirteenth  and 
seventeenth  days.  These  exhibited  a  more  advanced  stage  of 
ossification,  though  in  some  places  many  cells  were  seen  which 
were  not  cartilage  cells.  Between  the  broken  ends  the  inter- 
cellular substance  had  increased,  and  some  progress  had  been 
made  in  its  conversion  into  bone,  permitting  much  less  move- 
ment at  the  break.  At  other  portions  of  the  callus  canaliculi 
were  forming  in  the  intercellular  material,  and  which  evidently 
commenced  on  that  part  of  the  callus  most  remote  from  the 
lacunae.  The  entire  mass  of  new  bone  was  a  trifle  more  open 
and  spongy  in  its  texture  and  of  a  slight  rosy  tint.  Anxious  to 
determine  the  vascularity  of  the  reconstructing  substance,  on  the 
fifth  day  after  making  a  fracture  of  the  wing  of  a  chicken  a 
delicate  pipe  was  inserted  into  the  brachial  artery,  through 
which  I  injected  some  ultramarine  suspended  in  glycerin.  A 
section  was  made  of  the  bone  and  submitted  to  Dr.  Rhoads  for 
examination.  Although  the  injection  was  not  so  satisfactorily 
done  as  I  could  have  wished,  yet  the  coloring  matter  had  filled 
numerous  vessels  throughout  the  callus.  These  vessels  in  the 
external  callus  ran  for  the  most  part  perpendicularly  down,  the 
callus  ossifying  around  them. 

"  Two  additional  specimens,  one  twenty-one  and  the  other 
twenty-three  days  old,  were  carefully  studied.  The  appearances 
presented  were  entirely  in  harmony  with  the  previous  specimens. 
The  entire  reconstructing  material  had  been  converted  into  bone, 
so  that  scarcely  a  trace  of  cartilage  could  be  seen.  The  amount 
of  exterior  callus  had  diminished  and  become  more  compact, 
and  that  between  the  ends  of  the  bone,  though  much  less  per- 
fectly transformed  into  osseous  tissue  by  the  deposit  of  the  bone- 
salts  in  the  intercellular  substance  than  other  portions,  had 
nevertheless  made  material  progress. 

"Meescher  and  Votsch  state  that  ossification  in  birds  is 


DR.    AGNE\7'S    ORIGINAL    WORK   IN    SURGERY.  187 

always  in  cartilage  ;  Wagner  states  virtually  the  same  in  the  case 
of  rabbits,  and  in  all  the  cases  which  furnished  tlie  subjects  of 
the  present  experiments  the  same  fact  was  observed.  It  is 
asserted  that  in  man  the  repair  or  ossification  may  take  place 
either  in  cartilage  or  in  fibrous  or  fibro-cartilaginous  tissue. 

"  This  statement  needs  confirmation.  At  tlie  time  I  was 
engaged  in  these  experiments  a  patient  was  admitted  into  the 
Pennsylvania  Hospital  who  had  broken  his  femur  in  the  lower 
third  in  the  act  of  pulling  off  his  boot.  Six  weeks  later  the  man 
died,  and  I  had  the  opportunity  of  examining  the  bone.  Though 
the  fractured  limb  had  been  kept  perfectly  quiet,  the  appearance 
presented  was  identical  with  that  of  the  bones  which  I  had 
under  experiment.  There  was  the  same  spindle-shaped  swell- 
ing on  the  exterior  of  the  bone,  extending  for  two  inches  above 
and  below  the  fracture,  and  most  of  which  had  been  converted 
into  bone,  while  in  that  portion  between  the  ends,  and  where 
the  process  was  less  advanced,  lay  cartilage-cells  in  a  vitreous- 
like  matrix,  but  not  a  trace  of  connective  or  fibrous  tissue. 

"  Of  course,  it  would  be  unsafe  to  speak  dogmatically 
from  a  single  example,  but  it  is  sufficient  to  excite  a  doubt  as  to 
union  save  through  cartilage  tissue.  It  is  certainly  true  that 
the  amount  of  peripheral  callus  is  greatly  influenced  both  by 
the  relation  of  the  fragments  to  each  other  and  by  the  degree 
of  disturbance  to  which  they  are  subjected,  becoming  exu- 
berant when  there  is  overlapping,  and  especially  so  when  the 
ends  are  not  sufficiently  immobilized;  but  I  think  that  any 
one  who  will  study  the  fracture  specimens  in  our  museums 
will  be  convinced  that  in  all  long  bones,  whatever  may  be 
the  age  of  the  specimen,  there  is  manifest  evidence  of  an 
ensheathing  callus,  increasing  somewhat  the  volume  of  the 
bone  at  the  seat  of  injury.  The  conclusions  which  I  think 
are  rendered  probable  by  these  and  other  observations  are  the 
following : — 

"  First.  That  there  is  no  evidence  founded  on  structure 
that  the  process  of  healing  in  the  fractures  of  man  may  not  be 


188  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

studied  by  experiments  on  the  lower  animals,  or  that  the  repair 
in  the  latter  materially  differs  from  that  in  the  former. 

"  Second.  That  the  reparative  act  is  the  result  of  inflam- 
matory process. 

"  Third.  That  the  reparative  material  is  furnished  by  the 
vessels  of  the  periosteum,  endosteum,  and  bone,  and,  to  some 
extent,  by  those  of  the  adjacent  soft  parts. 

'■•Fourth.  That  the  uniting  material  is  deposited  external 
to  the  bone,  constituting  an  ensheathing  callus ;  also  in  the 
medullary  canal  when  there  is  no  displacement,  and  between 
the  ends  of  the  bones ;  that  the  conversion  of  this  preliminary 
substance  into  bone  proceeds  from  the  surface  towards  the  centre, 
so  that  the  exterior  is  hard  long  before  the  interior,  which  will 
account  for  the  movement  discoverable  in  specimens  apparently 
solidly  united  together. 

^''  Fifth.  That  the  union  of  bone  is  through  cartilage,  and 
even  through  cells  which  have  not  reached  the  typical  form  of 
cartilage,  and  in  this  respect  does  not  materially  differ  from  the 
process  observed  in  the  primary  development  of  bone. 

"  Sixth.  That  the  presence  of  the  ensheathing  and  medul- 
lary callus,  thought  to  be  exceptional  in  man,  should  be  considered 
the  rule. 

"  Seventh.  That  the  terms  temporary  and  provisional 
callus,  as  used  by  Dupuytren  in  contradistinction  to  the  defin- 
itive, must  be  accepted  with  considerable  limitation,  the  one  not 
differing  in  any  particular  of  composition  from  the  other;  that 
the  delay  in  the  production  and  bony  transformation  of  the  inter- 
mediate or  definitive  callus,  as  compared  with  the  exterior  and 
interior  portions,  is  due  only  to  the  comparatively  small  vascu- 
larity of  the  compact  part  of  the  bone. 

"  Eighth.  That  the  complete  absorption  of  the  ensheathing 
callus  never  occurs,  and  that  the  re-absorption  of  the  medullary 
callus  is  not  a  work  of  nature  set  in  operation  because  the  union 
at  the  ends  of  the  bone  has  become  complete,  but  is  simply  a 
repetition  of  the  order  followed  in  the  development  of  the  long 


DR.    AGNEW'S   ORIGINAL    WORK    IN    SURGERY.  189 

bones,  entirely  independent  of  tlie  fracture, — a  work  which  con- 
tributes both  to  tlieir  lightness  and  to  their  mechanical  strength. 

"  The  time  involved  in  the  whole  work  of  restoration 
varies,  no  doubt,  in  different  persons,  and  is  affected  by  various 
circumstances,  such  as  the  health  of  the  patient,  the  quiet  of 
the  parts,  and  the  accuracy  of  the  adjustment.  The  process  in 
its  entirety  may  be  described  as  follows : — 

"  First,  there  is  a  period  of  rest, — one  in  whicli  there  is  no 
visible  attempt  made  to  repair  the  damage.  All  seems  quiet. 
Everything  within  the  area  of  injury  remains  in  chaotic  con- 
fusion ;  and  as  an  architect,  before  he  begins  the  work  of  recon- 
struction, quietly  surveys  the  mass  of  ruins  of  some  noble  build- 
ing which  has  gone  down  under  a  sudden  catastrophe,  so  the 
genetic  forces  of  the  parts  seem  to  brood  silently,  for  a  time,  over 
the  scene  of  disorder  before  any  note  of  preparation  is  sounded. 
This  is  of  short  duration,  not  generally  extending  beyond  tliirty- 
six  hours.  Following  this  comes  a  reactionary  period,  in  which 
the  ordinary  phenomena  of  inflammation  are  present.  There  is 
an  increased  determination  of  blood  to  the  part,  accompanied 
by  a  transudation.  This  is  sometimes  very  considerable,  giving 
rise  to  much  swelling  and  an  exalted  sensibility  of  the  parts, 
and  may  continue  for  three  or  four  days;  so  that  tlie  first  five  or 
six  days  are  consumed  in  passing  over  the  stages  of  local  shock 
and  inflammatory  disturbance.  It  cannot  be  said  that  during 
this  time  any  true  reconstructive  work  has  been  inaugurated. 

"  In  this  respect  the  repair  of  fractures  in  lower  animals,  as 
chickens,  rabbits,  etc.,  differs  from  that  in  man.  In  the  former 
the  process  of  union  is  well  established  in  seven  or  eight  days. 
The  acute  symptoms  having  subsided,  another  period  of  three 
or  four  days  elapses,  during  which  a  part  of  the  inflammatory 
products  and  a  portion  of  the  extravasated  blood  and  other 
debris  consequent  upon  the  injury  are  removed,  and  the  tender- 
ness and  swelling,  as  well  as  the  irritability  of  the  surrounding 
muscles,  become  diminished.  The  vascularity,  however,  of  the 
bone,  periosteum,  and  endosteum  does  not  diminish,  but  rather 


190  LIFE   OF   D.    HATES    AGNEW,    M.D.,    LL.D. 

increases.  From  the  eighth  to  the  tenth  day  the  real  work 
of  repair  begins,  that  in  which  the  true  fibrogenous  matter, 
swarming  with  cellular  elements,  assumes  the  appearance  of 
order. 

"  The  differentiation  of  this  constructive  material  into  carti- 
lage or  fibro-cartilage  and  intercellular  substance,  and  the  subse- 
quent deposition  of  the  bone-salts,  ultimately  permeating  the 
mass  and  imparting  solidity  to  the  bone,  are  the  work  of  four 
or  five  weeks. 

"  Now,  while  we  have  divided  this  process  into  stages, 
allotting  to  each  an  approximate  number  of  days  or  of  weeks, 
it  must  not  be  supposed  that  these  gradations  are  sharply  de- 
fined, and  that  one  cannot  begin  until  the  other  is  ended ;  on 
the  contrary,  they  may  blend  or  co-exist,  and  can  only  be  re- 
garded as  approximately  true ;  but  they  are,  nevertheless,  con- 
venient for  purposes  of  description. 

"In  children,  union  will  often  occur  with  great  rapidity;, 
and  I  have  even  known  an  adult  with  a  fracture  of  the  femur  tO' 
rise  from  his  bed  and  walk  at  the  expiration  of  four  weeks ;  in- 
deed, I  am  convinced  that  the  healing  of  fractures  takes  place 
at  an  earlier  period  than  is  generally  believed. 

"  Such  is  the  ordinary  mode  of  repair.  It  is  alleged  by- 
some  that  where  the  apposition  is  very  perfect,  as  where  the 
fragments  rest  end  to  end  or  edge  to  edge,  or  where  there  is  an 
incomplete  separation  of  the  fibres  of  the  bone,  immediate 
union  may  take  place,  just  as  it  is  alleged  to  occur  under  favor- 
able circumstances  in  the  soft  parts.  I  have  never  seen  any 
specimen  which  would  induce  me  to  adopt  such  a  conclusion. 

"  In  compound  fractures  the  existence  of  an  external 
wound  and  the  suppuration  which  ensues  modify  the  plan  of 
restoration.  The  work  is  greatly  delayed,  and  the  imion  is 
eff'ected  through  a  larger  amount  of  granulation  than  in  simple 
fractures,  which,  after  its  transformation  into  fibro-cartilaginous 
tissues,  becomes  incorporated  with  the  lime  deposits.  In  other 
words,  the  difference  between  the  healing  of  simple  and  that  of 


DR.    AGNEW'S    ORIGINAL   WORK    IN    SURGERY.  191 

compound  fractures  is  much  like  that  between  the  heaUng  of 
subcutaneous  and  that  of  open  wounds. 

"  In  compound  comminuted  fractures  the  healing  is  still 
longer  delayed.  Detached  portions  of  the  bone  die  from  losing 
their  connection  with  the  periosteum  and  tlie  medullary  tissue, 
and  from  the  influence  of  the  inflammatory  products.  The 
work  of  reparation  is  delayed  until  the  sequestra  are  got  rid  of, 
after  whicli  granulations  spring  up  abundantly  from  the  medul- 
lary and  periosteal  tissues  and  undergo  ossification.  The  time 
required  for  the  separation  of  such  necrosed  portions  may  be 
so  great  that  the  restorative  powers  entirely  fail,  and  no  union 
will  take  place ;  or,  if  united,  the  connection  is  established  in  a 
large  sheath  of  irregular  callus,  without  any  cohesion  of  the 
ends  of  the  fragments  to  each  other.  It  is  in  such  fractures 
that  we  often  find  the  hard  and  the  soft  parts  extensively  glued 
together  by  inflammatory  lymph.  AVhere  there  is  loss  of  bone, 
in  most  cases  there  will  be  shortening,  particularly  in  the  adult ; 
although,  as  shown  by  M.  Oilier,  the  preservation  of  the  peri- 
osteum will  often  provide,  to  some  extent,  against  this,  by 
supplying  the  material  for  partially  bridging  the  gap. 

"  When  a  cartilage  is  broken,  the  perichondrium  behaves 
like  the  periosteum,  furnishing  the  material  for  a  bond  of 
union,  which  consists  not  of  cartilage,  but  of  bone,  and  which 
envelops  the  parts  like  a  firm  ring,  but  often  not  filling  the 
intermediate  space,  or  that  between  the  ends  of  the  fragments. 
An  epiphysis,  when  detached  from  its  diaphysis,  although  the 
original  conjunction  was  one  of  cartilage,  will  afterwards  unite 
by  bone ;  and  as  the  bones  grow  in  length  by  a  deposit  in  the 
cartilage  which  exists  between  the  ends  of  the  shaft  and  the 
epiphyses,  it  has  been  stated  that  in  such  fractures  the  bone 
ceases  to  grow  in  the  longitudinal  direction.  I  have  reason  to 
doubt  the  correctness  of  this  statement,  believing  that,  although 
no  increase  in  length  may  take  place  at  the  injured  part,  the 
failure  is  compensated  for  by  increased  activity  in  the  nutrition 
of  the  intermediate  cartilage  at  the  other  extremity.     Fractures 


192  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D.. 

which  extend  through  the  articular  incrusting  cartilage  seem  to 
have  no  power  to  unite.  There  are  other  fractures  which  do  not 
unite  by  callus.  They  are  such  as  are  subjected  to  the  influence 
of  the  synovial  fluid,  or  whose  vascular  supply  is  insufiicient. 
Among  these  are  fractures  of  the  neck  of  the  femur  within 
the  capsular  ligament,  of  the  head  of  the  humerus,  of  the 
olecranon  process  of  the  ulna,  and  of  the  acromion  process  of 
the  scapula.  Fractures  of  the  patella  generally  come  under 
the  same  category." 


CHAPTER  IX. 

Dr.  Agnew  as  a  AVriter. 

As  has  been  said,  Dr.  Agnew  was  not  a  prolific  writer; 
his  articles  were  numerous,  but  not  in  comparison  to  the  lists 
of  many  of  his  colleagues  and  the  length  of  his  life ;  they  were 
always  in  response  to  some  well-defined  demand. 

The  following  is  the  list  of  the  books  and  articles  published 
by  Dr.  Agnew.  The  majority  of  these  are  reports  of  his  clinical 
lectures  written  not  by  himself,  but  by  medical  reporters  : — 

The  List  of  the  Books ^  Articles,  and  Addresses  Published  by 

Dr.  Agnew. 

1856.  Practical  Anatomy  ;    a  New  Arrangement  of  the  London  Dis- 

sector.    2d  edition,  1867. 
Valedictory  Address,  Pliiladelphia  Scliool  of  Anatomy. 

1857.  Valedictory  Address,  Philadelphia  School  of  Anatomy'. 
Theatrical  Amusements. 

1858.  Yaledictor}^  Address,  Pliiladelphia  School  of  Anatomy. 

1859.  Introdnctor}^  Address,  Philadelphia  School  of  Anatomj'. 
Valedictory  Address,  Philadelphia  School  of  Anatomy. 
Obituary  Notice  on  Frederick  S.  Geiger,  M.D. 

1859-64.     Sixty  articles  :    "  Anatoni}' in  its  Relations  to  Medicine  and 

Surgery.'"     lledical  and  Surgical  Beporter. 
1859-71.     Clinical  Reports.     Medical  and  Surgical  Beporter. 

1860.  Valedictory  Address,  Philadelphia  School  of  Anatonn'. 
Introductory  Address,  "  Classification  of  the  Animal  Kingdom." 

1861.  Address,  "  Baron  Larrey." 

1862.  History  of  the  Philadelphia  Almshouse  Hospital.     Reprinted  in 

Philadelphia  Hospital  Reports,  1890,  vol.  i,  p.  I. 

1865.  Lacerations  of  the  Female  Perineum. 

1867.  Vesico-Vaginal  Fistula. 

1870.  Introductory  Lecture,  University  of  Pennsjdvania. 

1875.  President's  Address,  Philadelphia  County  Medical  Society. 

1876.  "Address  on  Surgery,"  Pennsylvania  State  Medical  Societ3^ 

1877.  "Hydrocele."     G.  P.  Putnam  &  Sons. 

''  (193) 


194  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

18T8.  "Attitude  and  Expression  in  the  Diagnosis  of  Surgical  Diseases." 
New  York  Medical  Record,  vol.  xiv,  pp.  424-26. 

"  Errors  of  Diagnosis."  President's  Address,  Pennsylvania  State 
Medical  Society. 

Principles  and  Practice  of  Surger3^  vol.  i,  2d  edition,  1889. 

1879.  "  Popliteal  Aneurism."     Hospital   Gazette,  vol.  vi,  p.  387. 
Biographical  sketch  of  Dr.  John  Rhea  Barton.     Delivered  at  the 

Academy  of  Music,  at  the  annual  Commencement  of  the  Med- 
ical Department. 

"  Pistol-Sliot  Wound  of  the  Hand."  Hospital  Gazette,  yoI.  vi,  p. 
369. 

"Nsevus."      Cincinnati  Lancet- Clinic,  n.  s.,  vol.  iii,  p.  484. 

1880.  "Anchylosis    of  the   Elbow-Joint    Following   Dislocation,  in   a 

Medico-Legal  Aspect."  Boston  Medical  and  Surgical  Journal, 
vol.  ciii,  p.  33. 

1881.  "  General  Principles  of  Surgical  Diagnosis."     International  En- 

cj^clopsedia  of  Surger}-,  vol.  i,  p.  337. 

"  Treatment  of  Vesical  Catarrh  hy  Establishing  Urinary  Eistulse." 
Philadelphia  Medical  Times,  vol.  xi,  p.  300. 

"  Traumatic  Tetanus."  Medical  and  Surgical  Rep)orter,  Phila- 
delphia, vol.  xliv,  p.  654. 

'  Popliteal  Aneurism  ;  Cure  by  Ligation."  Medical  and  Surgical 
Reporter,  Philadelphia,  vol.  xlv,  p.  151-2. 

"  Clinical  Remarks  on  Lithotom}'  in  Children  and  its  Complica- 
tions."    New  York  Medical  Record,  vol.  xx,  p.  681. 

Principles  and  Practice  of  Surgery,  vol.  ii. 

1882.  Lacerations  of  the  Female  Perineum  and  Vesico-Yaginal  Fistula. 
"Abstract  of  a  Clinical  Lecture  on  the  Recognition  of  the  Early 

Stages  of  Pott's  Disease."     Medical  News,  vol.  xl,  p.  4. 

"  Clinical  Lecture  on  Stone  in  the  Bladder."  Virginia  Medical 
Monthly,  Richmond,  vol.  ix,  p.  12. 

"A  Case  of  Chronic  Cystitis."     Medical  Record,  vol.  xxii,  p.  92. 

"  Ununited  Fracture  of  the  Neck  of  the  Femur."  3Iedical  and 
Surgical  Reporter,  Philadelphia,  vol.  xlvii,  p.  65. 

"Abscess  of  the  Pharj'ux."  Medical  and  Surgical  Reporter^ 
Philadelphia,  vol.  xlvii,  p.  65. 

'"  Yesical  Calculus  ;  Removal  by  Lateral  Lithotom3\"  Philadel- 
phia Medical  Times,  \o\.  xiii,  p.  539. 

1883.  "Traumatic  Urinary  Fistula ;  External  Perineal  Urethrotom}-." 

Philadeljjhia  Medical  Times,  vol.  xiii,  p.  721. 
"  Necrosis  of  the  Tibia."     Philadeljphia  Medical  Times,  vol.  xiii^ 
p.  791. 


DR.    AGNEW    AS    A    WRITER.  195 

1883.     "  Osteotomy  upon  the  Left  Superior  Maxilla  for  the  Removal  of 
Post-nasal  Fibrous  Polypus."     Medical  News,  vol.  xliii,  p.  141. 
Principles  and  Practice  of  Surgery,  vol.  iii. 

1885.  "Note  on  the  Use  of  Salvia  Officinalis  in  Catarrhal  Rhinitis." 

Therapeutic  Gazette,  3,  s.  1,  p.  IT. 
Memoir  of  Elias  R.  Beadle,  D.D. 
Valedictory  Address,  Commencement  of  Medical  Department. 

1886.  "  Painful  Muscular  Spasm  Treated  by  Excision  of  Portion  of  the 

Nerve-Trunk."     Medical  Times,  vol.  xvi,  p.  279. 

"Memoir  of  John  Light  Atlee."     Transactions  of  the  College  of 
Physicians. 
188T.     "  Nephrorrhaphy  and  Nephrectomy."    Medical  Neivs,  vol.  1,  p.  116. 

"  Excision  of  the  Larynx  and  Pharynx."  Medical  News,  vol.  1. 
p.  401. 

"  Medico-Legal  Aspect  of  Cranial  and  Heart  Wounds."  Trans- 
actions of  the  American  Surgical  Association;  also,  Medical 
News,  vol.  1,  p.  561. 

"  Nephro-lithotoniy."     Medical  News,  vol.  1,  p.  682. 

"  A  Death  During  and  a  Death  Before  the  Administration  of 
Ether."     Medical  News,  vol.  li,  p.  589. 

1888.  "Nephro-lithotomy."     Medical  News,  vol.  Iii,  p.  115. 

"  The  Relation  of  Social  Life  to  Surgical  Disease."  Transactions 
of  the  American  Surgical  Association ;  3Iedical  News,  Phila- 
delphia, vol.  liii,  p.  316. 

"  Laparotomy  with  Excision  of  a  Portion  of  the  Ileum."  Medical 
and  Surgical  Reporter^  vol.  lix,  p.  321. 

"  Practical  Observations  on  Senile  H3-pertrophy  of  the  Prostate 
Gland."     University  Medical  Magazine,  vol.  i,  p.  1. 

1889.  "  Tracheotomy."      University  Medical  Magazine,  vol  i,  p.  519. 

"  The  Choice  of  Operations  for  Vesical  Calculus."  University 
Medical  Magazine,  vol.  ii,  p.  1. 

"  The  Radical  Treatment  of  Hernia."  University  Medical  Maga- 
zine, vol.  ii,  p.  339. 

Address,  Opening  Exercises  at  the  House  of  Refuge. 
1889-91,     President's  Addresses.      Transactions  of  the  College  of  Phy- 
sicians. 

1890.  "  Injuries    to    the    Peroneus    Longus   Tendon   and   its    Sheath." 

University  Medical  Magazine,  \o\.  iii,  p.  1. 

1891.  "  Pancreatic  C3^st.     Removal  b}^  Laparotomy  ;  Recover3^"     Uni- 

versity 3Iedical  Magazine,  vol.  iii,  p.  469. 
"  Pistula  of  the  Duct  of  Steuo."      University  Medical  Magazine^ 
vol.  iii,  p.  583. 


196  LIFE   OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

1891.  "  The  Present  Status  in  Brain  Siu-ger}^  Based  on  tlie  Practice  of 
Philadelphia  Surgeons."  University  Medical  Magazine^  vol. 
iv,  p.  IT. 

Dr.  Agnew  could  wield  a  pen  exhibiting,  to  a  marked 
degree,  sarcastic  retort,  combined  with  humorous  comparisons ; 
for  example,  in  talking  of  religious  subjects  he  said,  in  regard 
to  certain  persons,  that  "  their  minds  are  first  made  up  to  a 
judgment,  and  then  the  Bible  is  subpenaed  for  its  defense,  ques- 
tioned and  cross-questioned,  threatened  and  coaxed,  put  upon  the 
rack  of  criticism  and  interpolation,  a  sentence  seized  upon  here 
and  another  there,  and  these  are  all  marshalled  into  line,  contrary 
to  every  rule  of  grammar  and  logical  interpretation,  until  an 
opinion  is  formed  wreaking  with  the  blood  of  violence.  It  is 
not  'Speak,  Lord,  for  thy  servant  heareth,'  with  these  people, 
but  'Hear,  Lord,  for  thy  servant  speaketh.'" 

There  was  a  picturesqueness  about  his  style  which  gives  a 
dash  to  all  of  his  productions,  however  dry  their  character. 
For  example,  in  speaking  on  a  political  subject,  he  said :  "  The 
heart  of  the  old  Whig  party  throbbed  its  last  pulsations  with 
the  death  of  Henry  Clay,  and  the  American  organization  known 
by  the  sobriquet  of  'Know-Nothing,'  which  came  forth  with 
the  growth  of  a  fungus  in  a  night,  like  Jonah's  gourd,  has 
passed  away  as  the  morning-dew,  leaving  the  shillalah  and 
shamrock  as  invincible  as  ever." 

Li  speaking  of  certain  members  of  the  Board  of  Guardians, 
he  said :  "  They  clung  to  office  like  barnacles  to  a  ship's 
bottom." 

Li  the  early  part  of  this  biography  a  valedictory  address, 
delivered  by  Dr.  Agnew  at  the  School  of  Anatomy,  was  given, 
which  casts  interesting  side-lights  on  Dr.  Agnew's  thoughts, 
education,  and  beliefs  of  that  day ;  in  Chapter  VHI  are  given 
two  examples  of  his  style  of  pursuing  strictly  scientific  investi- 
gations ;  later  in  the  work  will  be  given  his  last  didactic  lecture. 
There  remain  yet  two  phases  of  his  career  as  a  writer  untouched. 
One  is  his  manner  of  preparing  an  ordinary  medical  essay ;  the 


DR.    AGNEW    AS    A    AVRITER.  197 

other,  liis  expression  of  his  belieis  on  tlie  relations  between  his 
profession  and  ordinary  daily  life. 

They  are  all  easy  reading,  for  Dr.  Agnew  always  used 
the  simplest,  most  direct  words  and  statements  in  dealing 
with  any  subject.  Two  of  them  are  given  here,  as  a  sample 
of  his  work;  the  first  paper  shows  his  clearness  of  thought 
and  argument  in  dealing  with  a  difficult  medical  question  which 
has  become  a  knotty  legal  problem;  while  the  other  paper 
is  on  the  interesting  subject  of  the  "Relation  of  Social  Life 
to  Surgical  Disease."  Both  were  read  before  the  American 
Surgical  Association  and  published  in  TJie  Medical  Neics  of 
Philadelphia. 

These  papers  require  no  explanation,  wliile  they  throw 
incidentally  more  side-lights  on  Dr.  Agnew's  nature,  life,  and 
character  than  would  many  pages  of  description  : — 

MEDICO-LEGAL  ASPECTS  OF  CRANIAL  AND  HEART  WOUNDS. 

An  Address  Delivered  before  the  American  Surgical 
Associatioyi. 

Is  it  possible  for  an  individual,  with  suicidal  intent,  and  in 
quick  succession,  to  inflict  a  perforating  shot  wound  of  the  head 
and  another  of  the  chest  implicating  the  heart?  Or,  reversing 
the  proposition,  is  it  incredible  that  a  person,  bent  on  self- 
destruction,  can,  with  his  own  hand,  shoot  himself  in  the  heart 
and  in  the  head] 

These  questions  have  a  medico-legal  bearing  of  no  small 
import,  and  have  been  suggested  as  the  subject  of  the  present 
paper  by  a  murder  committed,  during  the  spring  of  1886,  in 
the  town  of  Newport,  Rhode  Island. 

A  colored  man,  long  a  resident  of  Newport,  well  known 
both  to  the  permanent  inhabitants  of  and  to  many  of  the  tran- 
sient visitors  to  this  place  of  fashionable  resort,  was  found,  one 
morning  in  his  house,  dead  under  the  breakfast-table,  having  in 
his  mouth  some  food  unswallowed,  and  with  a  bullet  wound  in 
his  head  and  another  in  his  chest.     A  coroner's  jury,  after  hold- 


198  LIFE    OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

ing  an  inquest,  brought  in  a  verdict  of  suicide,  and  the  body, 
under  this  finding,  was  interred. 

Some  weeks  later,  through  the  suggestion,  I  believe,  of  one 
of  the  local  physicians,  that  it  was  impossible  for  the  deceased 
to  have  inflicted  these  double  wounds  with  his  own  hands,  both 
involving  vital  organs,  the  authorities  ordered  the  body  to  be 
disinterred  and  the  inquest  to  be  reviewed.  The  autopsy  re- 
vealed a  perforating  shot  wound  of  the  skull,  the  pistol-ball 
(22-calibre)  having  entered  the  right  parietal  bone,  about  two 
inches  above  and  anterior  to  the  ear,  making  a  clear-cut  perfo- 
ration of  the  skull  and  lodging  in  the  posterior  part  of  the  left 
half  of  the  cerebrum,  having  passed  from  left  to  right  and  from 
before  backward. 

Another  ball  had  penetrated  the  thorax  at  a  point  three 
inches  to  the  right  of  the  left  nipple  and  two  inches  to  the  left 
of  the  median  line.  "  The  ball,"  as  was  stated,  "  was  found  to 
have  passed  through  the  left  ventricle  of  the  heart,  entering  the 
base  and  emerging  at  the  apex."  It  is  probable  that  the  exact 
point  at  which  the  ball  entered  the  chest  was  not  accurately 
noted,  as  it  would  have  been  an  anatomical  impossibility  for 
the  missile,  entering  the  thorax  at  the  position  stated,  to  have 
traversed  the  heart  from  base  to  apex,  the  base  of  the  organ 
beino-  on  a  level  with  the  second  costal  cartilage. 

The  finding  of  the  coroner's  jury,  based  on  the  evidence 
developed  by  this  second  examination,  was  "  murder  by  some 
person  or  persons  unknown."  Suspicion  now  fell  upon  the  son- 
in-law  of  the  dead  man,  who  lived  at  home  with  his  father- 
in-law. 

This  colored  man,  named  Dorsey%  was  a  graduate  of  Lin- 
coln University  and  had  attended  two  courses  of  instruction  in 
the  Medical  Department  of  the  University  of  Pennsylvania. 
He  was  immediately  arrested,  imprisoned,  and  held  to  answer 
for  the  murder.  He  stoutly  denied  any  participation  in  or 
knowledge  of  the  crime,  and  as  the  young  man  had,  both  dur- 
ing his  student  life  at  Lincoln  University  and  at  the  Medical 


DR.    AGNEW    AS    A    WRITER.  199 

Department  of  the  University  of  Pennsylvania,  borne  a  remark- 
ably excellent  character,  and  as  no  possible  or  sufficient  motive 
at  the  time  could  be  divined  for  such  an  act,  many  of  his  friends 
were  disposed  to  regard  him  as  innocent.  These  convictions 
were  strengthened  by  the  rumor  that  Burton,  the  murdered 
man,  was  hopelessly  embarrassed  financially  and  had,  I  under- 
stand, on  the  very  morning  of  his  death,  a  note  at  maturity, 
without  the  means  to  cancel  it. 

At  the  trial  of  Dorsey,  the  prisoner,  five  medical  experts 
were  examined  on  behalf  of  the  prosecution.  One  witness  tes- 
tified that  either  wound  must  have  caused  nearly  instant  death ; 
or,  if  the  brain  received  the  first  ball,  such  a  degree  of  uncon- 
sciousness would  have  ensued  as  to  incapacitate  the  victim  for 
inflicting  the  second  wound. 

A  second  witness  declared  that  the  wounds  were  entirely 
inconsistent  with  the  idea  of  suicide.  The  three  remaining  wit- 
nesses testified  that  if  not  more  than  one  minute  elapsed  be- 
tween the  shots,  the  case  was  one  of  homicide  and  not  suicide. 
Such  were  the  answers  as  given  to  me  by  the  prosecuting  attor- 
ney in  the  case.  Entertaining  a  different  view  from  that  ex- 
pressed by  the  medical  experts.  Dr.  William  Hunt,  one  of  the 
surgeons  of  the  Pennsylvania  Hospital,  and  myself,  at  the 
urgent  solicitation  of  the  friends  of  the  prisoner,  went  to  New- 
port on  the  last  day  of  the  trial.  We  arrived  at  the  place  in 
the  night,  expecting  to  go  on  the  witness-stand  the  following 
morning ;  but,  in  the  meantime,  the  trial  was  brought  to  a  sud- 
den termination  by  the  confession  of  the  prisoner's  wife,  in 
which  both  her  husband  and  herself  were  implicated  in  the 
murder.  And  now  the  question  recurs, — are  such  wounds  as 
those  described  inconsistent  with  the  idea  of  suicide  ? 

If  the  testimony  given  by  the  medical  experts  in  the  case 
just  detailed  is  to  pass  unchallenged,  then  it  follows  that  an 
innocent  person,  arrested  and  tried  for  murder  in  a  case  where  a 
shot  wound  of  the  head  and  of  the  heart  existed,  might  be  con- 
demned to  death,  even  though  the  other  evidence  did  not  raise 


200  LIFE   OF   D.    HATES    AGNEW,    M.D.,    LL.D. 

the  connection  of  the  prisoner  with  the  deed  above  a  mere 
possibiHty.  In  examining  this  question,  I  shall  assume  that  it 
is  possible  for  a  shot  wound  of  the  head  and  of  the  heart 
to  be  suicidal ;  and  as  to  the  precedence  of  injury, — the  head 
or  the  heart, — it  is  not  essential  to  the  case. 

First,  however,  let  us  consider  the  subject  in  the  order  of  a 
shot  wound  of  the  head  and  of  the  heart.  There  are  two  con- 
ditions which  would  disqualify  an  individual  bent  on  self- 
destruction  from  inflicting-  the  second  wound  in  the  chest, 
namely,  the  suspension  or  loss  of  consciousness  and  paralysis, 
partial  or  complete,  of  one  or  both  upper  extremities.  The  loss 
of  consciousness,  in  a  given  shot  wound  of  the  brain,  is  not  due 
to  the  mere  passage  of  the  missile  through  cerebral  matter. 
You  can  thrust  a  finger,  a  trocar,  or  a  knife  into  portions  of 
the  brain,  without  aff'ecting  either  sensibility  or  consciousness. 
Loss  of  consciousness  is  due  generally  either  to  fragments  of 
bone  carried  before  the  vulnerating  body  and  buried  in  the 
cerebrum,  to  some  large  vessel  or  sinus  being  open,  causing  pro- 
fuse hemorrhage,  or  to  transmitted  vibrations  resulting  from  the 
impact  of  a  ball  against  the  skull,  thus  causing  a  molecular 
disturbance  of  its  contents  and  momentarily  deranging  the 
orderly  operation  of  the  intellect. 

Indeed,  I  believe  that  the  sudden  suspension  of  conscious- 
ness in  many  of  these  shot  injuries  of  the  head  is  due  more  to 
this  contact  of  the  missile  with  the  cranial  wall  than  to  its 
passage  through  the  brain.  It  is  common  to  see  a  person  fall  to 
his  knees  or  prone  upon  the  ground  when  struck  upon  the 
head  by  a  pebble  or  fragment  of  a  stone ;  in  an  instant  he  is 
again  on  his  feet.  The  fall  does  not  necessarily  imply  loss  of 
consciousness,  though  it  does  mean  an  interruption  to  muscular 
co-ordination. 

Every  surgeon  can  recall  instances  of  the  most  dreadful 
injury  to  the  skull  and  brain  without  destroying  the  conscious 
volitions  of  the  patient.  During  1885  Dr.  William  Hunt  and 
myself  were  called  to  see  a  man  who  had  been  run  over  by  a 


DR.    AGNEW    AS    A    WRITER.  201 

street-railway  sweeper  during  the  iiiglit.  lie  was  seen  to  arise 
immediately  after  tlie  accident  and  walk  to  his  house,  on  Spruce 
Street,  two  squares  from  the  scene  of  injury.  Opening  the  door 
with  his  dead-latch  key,  he  passed  up-stairs  to  his  room,  on  the 
second  story,  and  went  to  bed.  The  family  in  the  morning 
found  him  unconscious.  On  examination,  portions  of  the  parie- 
tal and  temporal  bones  were  found  driven  deeply  into  the  brain. 

A  prominent  physician  of  Philadelphia  was  run  over  by 
an  unmanageable  horse,  and  dashed  against  the  corner  of  an 
iron  pillar,  causing  a  frightful  comminuted  and  depressed  frac- 
ture of  the  frontal  bone,  tearing  the  membranes  of  the  brain 
and  injuring  its  substance.  I  applied  the  trephine  in  two  places 
and  removed  twenty-seven  pieces  of  bone,  and  yet,  although 
unable  to  stand,  neither  mobility  nor  consciousness  was  de- 
stroyed, for  the  patient  gave  intelligent  instructions  in  reference 
to  being  carried  to  his  home. 

I  recall  another  case  of  still  more  extensive  damage  to  the 
skull ;  one  in  which,  by  the  bursting  of  a  fly-wheel,  quite  one- 
half  of  the  frontal  bone  was  carried  away,  and  with  it  a  consider- 
able portion  of  the  prefrontal  lobes  of  the  cerebrum.  Only  for 
a  few  moments  was  the  man  dazed;  he  ultimately  made  a  good 
recovery. 

The  famous  case  occurring  in  the  practice  of  Dr.  Harlow, 
and  figured  in  some  of  the  books  on  surgery,  is  another  one  in 
point.  A  bar  of  iron,  having  entered  the  face  below  the  zygoma, 
passed  through  the  skull  and  the  brain,  emerging  near  the 
vertex,  without  destroying  consciousness.  A  private  ("Surgical 
History  of  the  War,"  part  i)  named  Solomon,  Company  G, 
New  Jersey  Volunteers,  received  a  shot  wound  at  the  Battle  of 
Bull  Run.  The  ball  entered  the  skull  below  the  tip  of  the  left 
ear ;  the  mau  fell,  but  retained  his  senses.  The  surgeon  passed 
a  probe  two  inches  into  the  brain  in  the  track  of  the  ball. 

In  a  letter,  received  recently  from  Sir  William  INIacC'ormac, 
of  London,  the  writer  says  that  he  thinks  it  entirely  within  the 
bounds  of  possibility  for  an  individual  with  suicidal  intent  to 


202  LIFE   OF   D.    HATES    AGNEW,    M.D.,    LL.D. 

shoot  himself  in  the  head  and  in  the  heart,  or  in  the  heart  and 
afterward  in  the  head,  and  furnishes  the  following  cases,  w^hich 
render  such  a  statement  entirely  possible :  The  first  was  that 
of  a  suicidal  case,  under  the  care  of  Mr.  Hulke,  w^here  the  ball 
traversed  the  head  from  temple  to  temple,  but  did  not  emerge. 
The  patient  lived  fourteen  days,  but  did  not  lose  his  conscious- 
ness until  a  short  time  before  his  death ;  he  was  fully  able  to 
inflict  any  other  wound  had  he  been  so  disposed.  In  a  second 
case,  under  the  care  of  Dr.  Smith,  a  bullet  traversed  the  skull 
from  temple  to  temple ;  the  patient  not  only  preserved  his  con- 
sciousness, but  finally  recovered. 

A  soldier  at  the  Battle  of  Pultuska,  in  Poland,  as  related 
by  Hennen,  received  a  remarkable  wound  of  the  brain.  A  ball 
carried  away  the  bayonet  of  a  musket,  which  entered  the  right 
temple  of  the  man  two  inches  above  the  orbit,  and,  passing 
backward  and  downward,  emerged  through  the  maxillary  sinus 
of  the  left  or  opposite  side.  The  soldier,  aided  by  two  com- 
rades, tried  in  vain  to  withdraw  the  weapon.  The  surgeon- 
major,  M.  Fordeau,  made  a  similar  attempt  and  failed,  when  at 
length  the  task  was  accomplished  by  a  strong  soldier  placing 
the  man's  head  upon  the  ground  and  his  foot  upon  the  head 
and  making  traction  upon  the  missile.  The  patient  ultimately 
recovered,  and,  as  it  is  distinctly  stated  that  he  joined  his  own 
eff'orts  with  those  of  his  fellow-soldiers  in  their  attempts  at 
extraction,  it  follows  that  neither  consciousness  nor  motility 
was  lost. 

The  second  disqualifying  condition  for  inflicting  another 
wound  after  one  in  the  head  is  paralysis. 

The  very  great  advance  made  in  the  last  few  years  in 
regard  to  the  functions  of  the  brain  and  the  topographical  rela- 
tions existing  between  the  exterior  of  the  cranium  and  definite 
cerebral  convolutions  enables  us  to  locate  with  considerable 
accuracy  intra-cranial  lesions  from  the  symptomatic  phenomena 
which  may  be  present.  The  local  areas  or  centres  of  muscular 
power  have,  for  the  most  part,  been  clearly  established. 


DR.    AGNEW    AS    A    WRITER.  203 

It  will,  I  think,  be  conceded  that,  so  long  as  the  middle 
portion  of  the  ascending  frontal  and  corresponding  portion  of 
the  ascending  parietal  convolutions  remain  uninjured,  the  power 
to  use  the  arms  is  retained.  Tlic  motor  centres  are  all  grouped 
about  the  fissure  of  Rolando,  and,  unless  a  shot  or  other  missile 
trenches  on  these  special  regions,  motility  remains ;  although  it 
may,  after  a  time,  be  lost  by  the  extension  of  hemorrhage  or 
from  inflammatory  products.  So  common  is  it  to  see  sliot  and 
other  wounds  occurring  without  material  impairment  of  mus- 
cular motion  that  I  do  not  think  any  one  can  challenge  this 
statement.  Indeed,  the  cases  already  cited  in  support  of  per- 
sonal consciousness  after  wounds  of  the  brain  are,  most  of  them, 
equally  pertinent  when  applied  to  the  maintenance  of  motility. 
Nor  does  the  fact  that  a  man  falls,  or  is  unable  to  rise,  after  a 
perforating  shot  wound  of  the  skull,  prove  that  the  power  to 
use  his  arms  is  lost.  The  missile  may  damage  the  leg-centres 
and  not  affect  the  arm-centres. 

Let  us  next  change  the  proposition  by  altering  the  order 
of  wounds,  the  heart  wounds  taking  precedence. 

The  unconsciousness  and  loss  of  power  which  follow 
wounds  of  this  organ  are  due  to  hemorrhage  ;  the  vessels  of  the 
brain  and  other  nerve  centres  being  suddenly  emptied  of  their 
blood,  fatal  syncope  ensues;  hence  wounds  of  the  heart  are 
generally  considered  to  be  instantaneously  fatal.  Yet  there  are 
many — very  many — exceptions  to  this  rule.  Fischer,  in  an 
analysis  of  452  cases  of  wounds  of  the  heart,  gives  no  less  than  35 
recoveries;  72  were  shot  wounds,  with  1 2  recoveries.  Dr.  Purple, 
in  his  collection  of  heart  wounds,  states  that  in  42  cases,  12  of 
which  were  shot  wounds,  death  did  not  take  place  immediately. 

While  it  is  true  that  these  statistics  are  not  altogether  free 
from  criticism,  yet  they  possess  an  intrinsic  value  in  establishing 
the  general  statement  that  these  injuries  are  not  necessarily  or 
immediately  fiital  in  all  instances. 

The  following  cases,  culled  from  different  sources,  will  go 
to  sustain  the  object  most  needful  for  my  present  purpose.     In 


204  LIFE    OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

the  "  Surgical  History  of  the  War,"  part  i,  pages  530-31, 
there  is  recorded  the  case  of  Private  Inarming,  Co.  A,  Pennsyl- 
vania Volunteers,  who  was  shot  in  the  chest,  the  ball  entering 
the  right  auricle  of  the  heart.  The  patient  persisted  in  sitting 
up  and  walking  about  his  room.  He  lived  for  fourteen  days. 
The  same  author  mentions  the  case  of  a  private  named  Wright, 
Co.  C,  Fourth  Regiment  of  the  Veteran  Reserve  Corps,  shot  at 
Quincy,  111.,  who  lived  forty-six  hours.  The  ball  passed 
through  the  lung,  the  left  auricle,  the  auriculo- ventricular  sep- 
tum, and  the  left  ventricle. 

In  two  instances,  given  by  Jamain,  the  patients  lived  six 
months  after  a  shot  wound  of  the  left  ventricle  of  the  heart. 
Ferrus  mentions  a  case  in  which  a  man  lived  twenty  days  with 
a  skewer  through  his  heart. 

Sir  William  MacCormac  writes  me  that  Mr.  Durham  had 
a  case  of  bayonet  wound  of  the  heart,  in  which  the  patient  sur- 
vived fifty-six  hours.  The  wound  implicated  both  ventricles, 
the  septum  and  auricle,  and  yet  the  man  walked  some  yards 
after  receiving  the  injury.  Dr.  Andrews  reports  a  case  under 
the  care  of  Professor  Bergman,  of  Dorpat,  where  the  injured 
man  traveled  fifteen  miles  to  Dorpat  and  finally  recovered. 

In  the  Lancet,  January,  1879,  a  case  is  reported  where  a 
man  received  a  perforating  shot  wound  of"  the  left  ventricle, 
which  did  not  prove  fatal  for  fifty-four  days,  the  patient  having, 
in  the  meantime,  returned  to  his  work. 

In  Rankin's  "  Abstract  of  Medical  Sciences,"  vol.  xxxi,  page- 
165,  Mr.  Jackson  reports  the  case  of  a  man  who  received  two 
shot  wounds,  one  of  the  balls  passing  through  the  right  ven- 
tricle. He  lived  for  three  and  a  half  hours  and  was  able  in 
the  meantime  to  make  a  deposition  and  name  his  assassin.  A 
case  of  assassination  was  tried  before  a  British  court  in  India, 
A  native  named  Kadir  was  shot  through  the  heart,  June  2, 
1873,  while  lying  on  his  cot.  It  was  stated  in  evidence  that 
the  victim,  after  receiving  the  fatal  wound,  recognized  and 
denounced  his  murderer,  a  man  named  Meera  Khan.     On  the 


Dk.  Agnew  in  1879. 


DR.    AGNEW    AS    A    WRITER.  205 

strength  of  this  testimony  the  assassin  was  found  guilty.  An 
appeal  was  made  and  tlie  case  carried  to  another  court,  and  the 
verdict  reversed  on  the  ground  that  death  must  have  been 
instantaneous.  Mr.  W.  Curran,  Brigade-Surgeon,  in  comment- 
ing on  this  case,  stated  that  the  decision  of  the  former  court 
was,  in  his  judgment,  correct,  as,  in  his  own  personal  experience, 
shot  wounds  ol' the  heart  were  not  necessarily  immediately  fatal. 

On  May  11,  1812  {Lancet,  April  2,  1887),  Mr.  Percival 
was  shot  by  Bellingham  in  the  heart.  At  the  trial  a  witness 
testified  that  after  the  firing  he  saw  the  murdered  man  rush 
hastily  through  the  crowd  toward  the  place  where  he  was  stand- 
ing, looking  first  in  one  direction  and  then  in  tlie  other,  and,  after 
taking  a  few  steps  more,  reeled  and  fell  to  the  ground. 

I  may  also  mention  the  case  of  a  woman  brought  into  the 
surgical  ward  of  the  Pennsylvania  Hospital  during  my  term  of 
service.  The  left  ventricle  had  been  pierced  by  a  butcher-knife. 
She  survived  for  two  and  three-quarter  hours,  and  for  one-third 
of  that  time  her  mental  condition  was  perfectly  clear. 

Can  any  one  doubt  that,  in  most  of  the  cases  cited,  these 
patients,  had  they  been  so  disposed,  could  have  inflicted  a  shot- 
wound  of  the  head"? 

And  now,  third  and  last,  are  there  any  instances  in  which 
a  suicide  has  actually  inflicted  the  two  wounds  which  I  have 
been  considering'? 

Dr.  Macleod,  Professor  of  Surgery  in  Glasgow  University, 
Scotland,  furnishes  me  the  case  of  a  suicide  which  came  directly 
under  his  observation,  which  is  to  the  point.  A  student  shot 
himself  in  a  closet,  the  ball  entering  the  head.  Finding  that 
he  had  not  accomplished  the  work  of  self-destruction,  he  went 
to  his  bed-room,  along  a  passage,  and  shot  himself  in  the  heart. 
He  lived  only  a  few  moments  after  this  last  injury. 

In  turning  to  the  records  of  the  coroner's  physician  in 
Philadelphia,  I  am  able  to  furnish  the  following  cases: — 

1.  A  policeman  shot  himself,  first  through  the  head ;  the 
ball,  entering  the  right  temple,  was  found  lodged  in  the  cranial 


206  LIFE    OF    D.    HATES   AGNEW,    M.D,,    LL.D. 

vault  on  the  opposite  side.  A  second  shot  was  fired  into  his 
chest,  the  bullet  cutting  the  right  side  of  the  heart.  Death  from 
internal  hemorrhage  followed  in  about  five  minutes.  This  was 
done  in  the  presence  of  witnesses. 

2.  A  boy,  aged  19,  inflicted  four  shot  wounds  from  a  re- 
volver on  his  own  person.  The  first  bullet  entered  the  fore- 
head and,  after  taking  a  circuitous  route,  lodged  about  the 
middle  of  the  left  temporal  lobe.  A  second  ball  was  fired  into 
the  chest,  and,  passing  through  the  sternum,  cut  through  the 
left  ventricle  of  the  heart  on  a  level  with  the  mitral  valve.  A 
third  shot  passed  into  the  abdomen,  and  a  fourth  into  the  neck. 
Death  ensued  from  pericardial  hemorrhage. 

3.  A  grocer  was  found  dead  in  his  room,  having  locked 
the  door.  A  pistol  was  still  clutched  in  each  hand ;  one  bullet 
had  passed  through  the  brain  and  a  second  through  the  heart. 

4.  A  man  committed  suicide  in  the  park;  one  ball  entered 
the  brain,  a  second  the  chest. 

In  all  these  cases  the  suicide  was  not  assumed,  but  proved 
beyond  all  reasonable  doubt. 

From  the  foregoing  facts,  which  are  thus  hastily  thrown 
together,  I  think  I  am  at  liberty  to  draw  the  following  con- 
clusions : — 

First.  That  it  is  possible  for  a  ball  to  enter  the  bram  with- 
out destroying  consciousness,  although  it  may,  for  a  few  minutes^ 
cause  some  mental  confusion. 

Second.  That  a  ball  may  traverse  the  brain  w^ithout  caus- 
ing muscular  paralysis. 

TJiird.  That  a  suicide  may,  with  his  own  hands,  if  so  dis- 
posed, first  shoot  himself  in  the  head,  and,  within  the  lapse  of  a 
minute,  inflict  a  similar  wound  on  the  heart,  and  that  there  is  a 
sufiicient  number  of  cases  on  record  to  establish  the  feasibility 
of  the  self-infliction  of  the  two  shots;  and 

Fourth.  That  a  suicide  may  first  discharge  a  ball  into  the 
chest,  wounding  the  heart,  and  immediately  after  send  a  second 
ball  into  the  brain. 


DR.    AGNEW    AS    A    WRITER.  207 

In  the  second  article  by  Dr.  Agnew,  he  studies  the  ten- 
dencies of  modern  Hfe  as  related  to  surgical  disease.  It  has 
been  stated  by  many  authorities  that  this  essay  should  be  found 
in  every  household  in  America : — 

THE   RELATION   OF   SOCIAL   LIFE   TO   SURGICAL   DISEASE. 

PresidenVs  Address  Delivered  before  the  American 

Surgical  Association. 

There  is  no  tyranny  more  exacting  or  despotic  than  that 
exercised  by  the  conventionalities  which  govern  our  livin"-. 
All  stages  of  life,  from  infancy  to  old  age,  are  under  its  domi- 
nation. It  dictates  the  education,  the  manners,  the  walk,  the 
dress,  the  forms  of  speech, — in  fine,  the  whole  being.  Bevond 
all  contradiction,  the  behests  of  fashion  are  vastly  more  influ- 
ential in  governing  public  conduct  than  any  argument  drawn 
from  the  teachings  of  structure  and  function.  As  a  rule,  when 
the  conflict  is  between  taste  and  reason,  the  victory  will  be  on 
the  side  of  taste.  In  nothing  is  this  more  forcibly  displayed 
than  in  the  apparel  used  to  protect  the  body. 

It  is  not  an  agreeable  task  to  peer  into  the  wardrobes  or 
dressing-rooms  of  our  fair  country-women.  I  have  no  especial 
taste  for  exploring  museums  or  hizarre  collections.  Indeed, 
without  a  key  to  interpret  the  curious  and  ingenious  mechanisms 
for  clothing  the  form  divine,  such  an  exploration  would  be  like 
an  archseologist  attempting  Egyptology  ignorant  of  cuneiform 
inscriptions. 

I  have,  however,  some  knowledge  of  human  anatomy  in 
its  broadest  sense,  and  when  I  look  upon  the  master-pieces  of 
the  human  form,  whether  in  marble  or  on  canvas,  a  Belvidere 
Apollo  or  a  Venus  de  Medici,  and  contrast  these  with  the 
specimens  of  modern  men  and  women,  I  am  forced  to  admi- 
ration ;  not  so  much  at  the  amazing  ingenuity  displayed  in  con- 
cealing the  divinely  appointed  form  as  at  the  plasticity  and 
patient  submission  of  mortal  clay  under  the  despotism  of  a 
conventional  inquisition. 


208  LIFE    OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

Were  these  processes  of  mutilation  and  abnormality  harm- 
less,— did  the  body  consist  of  a  mere  mass  of  protoplasm  capable 
of  assuming  protean  shapes,  the  subject  might  be  passed  over 
with  the  feeling  of  a  naturalist ;  but  this  is  not  so.  These  vio- 
lations of  the  laws  of  structure  bring  with  them  serious  penal 
inflictions  which,  did  they  terminate  with  the  original  offender, 
might  be  dismissed  with  a  sentiment  of  pity ;  but  projecting,  as 
they  do,  their  baneful  consequences  to  successors,  they  become 
proper  subjects  for  criticism. 

Let  me  name  a  few  examples  as  illustrative  of  my  subject. 
For  some  time  the  profession  has  been  speculating  on  the 
causation  of  nasal  and  post-nasal  catarrh.,  with  its  accompany- 
ing auditory  defects,  the  growing  frequency  of  which  cannot 
have  escaped  general  observation.  Doubtless  no  single  agency 
will  explain  the  presence  among  us  of  tliis  unpleasant  disease ; 
yet  there  are  facts  connected  with  this  affection  which,  to  me, 
are  very  suggestive.  I  cannot  recall  an  instance  in  which  I 
have  met  with  the  disease  among  women  belonging  to  the 
Society  of  Friends,  Dunkards,  or  Mennonites.  If  this,  on  more 
extended  observation,  proves  to  be  true,  may  not  the  head-dress 
peculiar  to  these  people  be  accepted  in  explanation  of  their 
exemption. 

The  bonnet  which,  at  one  time,  overshadowed  the  entire 
head,  as  all  know,  has  been  gradually  shrinking  in  its  dimen- 
sions until  it  has  become  a  mere  shadow  of  its  former  self  and 
offers  no  protection  whatever  to  the  head.  As  a  substitute,  I 
would  not  insist  upon  the  quaint  head-gear  of  the  Friend, 
but  I  believe  that  any  modification  which  will  protect  this 
part  of  the  body  will  lessen  the  tendency  to  catarrhal  inflam- 
mation of  the  naso-pharyngeal  mucous  membrane. 

A  legion  of  physical  imperfections  arises  from  muscular 
restraint.  Among  these  may  be  mentioned  weak  ankles,  nar- 
row or  contracted  chests,  round  shoulders,  projecting  scapulae, 
and  lateral  curvature  of  the  spine. 

The  foolish  concession  to  appearance  and  the  unwise  par- 


DR.    AGNEW    AS    A    WRITER.  209 

tiality  of  parents  for  enforced  systems  of  education,  the  demands 
of  which  bear  no  just  proportion  to  the  capacity  of  the  juvenile 
mind,  constitute  the  initial  or  determining  force  of  these  phys- 
ical imperfections.  In  many  cases  the  weak  ankles  of  children, 
characterized  by  eversion  of  the  feet,  thus  allowing  the  super- 
incumbent weight  of  the  body  to  be  transmitted  to  the  latter, 
inside  of  the  proper  centre  of  support,  is  largely  chargeable  to 
the  miserable  practice  of  placing  on  the  little  ones,  long  before 
they  are  able  to  walk,  boots  tightly  laced  up  the  limb  some  dis- 
tance above  the  ankles.  The  confinement  of  the  flexor  and 
extensor  muscles  by  this  constriction  prevents  that  free  play  of 
movement  which  reacts  so  favorably  on  all  the  elements  of  an 
articulation,  and  that,  too,  at  a  time  when  the  growing  forces 
are  at  full  tide ;  so  that,  when  the  time  arrives  for  standing  and 
walking,  the  muscles  are  unequal  to  the  firm  support  of  the 
joint. 

The  consequence  of  this  feebleness  is  soon  seen  in  the  turn- 
ing outAvard  of  the  feet,  throwing  the  strain  on  the  internal 
lateral  ligaments,  which,  in  turn,  become  elongated  through 
growth,  and  thus  the  defect  becomes  established.  But  the  evil 
does  not  stop  here.  The  calcaneo-cuboid  and  the  astragalo- 
scaphoid  ligaments,  losing  the  proper  support  of  the  tendon 
of  the  posterior  tibial  muscle  under  the  abnormal  tension, 
begin  to  yield,  and  to  the  deformity  of  eversion  is  added  that 
of  "fi.at-foot."  That  this  is  not  a  mere  hypothetical  expla- 
nation of  the  ankle  defects  I  have  many  times  verified  by  find- 
ing the  threatening  symptoms  disappear  after  liberating  the 
imprisoned  muscles  and  subjecting  the  enfeebled  parts  to  a  ju- 
dicious massage.  Under  no  circumstance,  as  is  too  often  the 
case,  should  instrumental  apparatus  be  applied,  unless  in  cases 
in  which,  from  neglect,  the  deformity  is  thoroughly  established 
and  is  progressive. 

Take  another  deformity,  tliat  of  "  bow-legs."  On  the 
earliest  signs  of  the  unsightly  curve,  the  limb  is  too  often  tram- 
melled with  irons  and  the  growth  of  the  muscles  arrested,  when 


210  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

it  is  well  known  that  if  manual  force  be  systematically  applied 
two  or  three  times  a  day  the  limbs  will  gradually  assume  their 
typical  form. 

Again,  in  further  illustration  of  our  general  text,  take  as 
an  example 'a  child  who,  for  one  long  or  two  short  sessions  for 
five  days  of  the  week,  sits  over  the  study  desk,  compelled  to 
assume  a  position  in  wliich,  from  the  inclination  of  the  body, 
the  shoulders  fall  forward,  the  head  being  supported  generally 
on  the  elbows  and  the  hands.  In  such  a  posture  the  great  ser- 
ratus,  pectoralis  major  and  minor  muscles  are  in  a  state  of  rela"x- 
ation,  while  the  erector  spinse  and  trapezei  muscles  are  in  a  state 
of  tension.  This  change  in  the  position  of  the  shoulders  gives 
the  shoulder-blades  over,  without  antagonism  or  resistance,  to 
the  action  of  the  rhomboidei  and  the  levatores  angulae  muscles, 
which,  acting  conjointly,  cause  that  projection  of  the  lower 
anale  of  the  shoulder-blades  which  the  older  anatomists  termed 
"  scapulae  alatse." 

To  all  this  must  be  added  the  very  important  factor  of 
four  to  six  hours  in  the  school-room  and  two  hours,  at  least,  of 
home  preparation  for  the  following  day's  recitations,  during 
which  time  the  respiratory  functions,  having  been  reduced  to  a 
minimum  of  activity,  the  muscles  of  the  chest  are  comparatively 
passive  and  aeration  of  the  blood  tardy.  Certainly  no  combi- 
nation of  conditions  could  be  better  devised  for  forming  con- 
tracted chests  and  round  shoulders. 

It  is  not  long  before  the  watchful  eye  of  the  mother  detects 
the  change  in  the  figure  of  her  child.  She  will  probably  dis- 
cover this  condition  and  take  alarm,  even  when  the  pale  face, 
the  languid  air,  and  the  capricious  appetite  of  the  child  causes 
no  anxiety ;  and  then  comes  the  second  act  in  the  drama  of 
physical  deterioration, — a  resort  to  shoulder-braces  and  stays  in 
order  to  accomplish  that  which  the  muscles  should  be  taught  to 
do  without  restraint  or  incumbrance. 

While  it  is  true  that  lateral  curvature  of  the  spine  depends 
upon  causes  both  central  and  peripheral,  yet  in  no  small  num- 


DR,    AGNEW   AS   A    WRITER.  211 

ber  the  deformity  is  clearly  attributable  to  influences  of  a  social 
nature.  The  spinal  column,  by  reason  of  the  non-union  of  tlie 
epiphyses  and  diaphyses  and  the  supple  cliaracter  of  its  liga- 
ments, is  extremely  flexible.  Whatever,  therefore,  destroys  tlie 
muscular  equipoise,  however  inconsiderable  the  force,  if  per- 
sistently repeated,  changes  the  centre  of  gravity  and  develops 
primary  and  compensating  curves. 

For  nine  months  in  the  year,  any  fine  morning,  groups  of 
young  children  may  be  seen  plodding  along  our  streets  with  a 
miniature  library  of  books  suspended  from  one  shoulder.  To 
the  already  preponderating  scale  of  the  balance  add  the  addi- 
tional factor,  a  badly-arranged  light  in  the  school-room,  com- 
pelling these  little  savants  to  assume  a  lateral  inclination  of  the 
body  in  order  to  obtain  the  necessary  illumination  of  the  sub- 
jects of  study,  and  you  have  all  the  conditions  necessary  for 
perpetuating  the  lateral  deformity.  "  Just  as  the  twig  is  bent 
the  tree's  inclined."  As  in  the  case  of  round  shoulders,  in 
order  to  prop  up  the  falling  column,  instrumental  contrivances 
are  immediately  called  into  requisition.  The  body  is  encased 
in  a  formidable  coat  of  mail,  to  be  followed  by  muscular  atro- 
phy and  permanent  distortion  of  the  most  beautiful  piece  of 
mechanism  in  the  human  frame. 

It  is  true  that  in  most  educational  institutions  for  the 
young  provisions  are  now  made  for  physical  culture,  and  these 
are,  in  some  measure,  antidotal  to  the  evils  complained  of;  but, 
in  my  judgment,  these  factors  do  not  at  all  compensate  for  that 
free  unstudied  romp  in  the  open  air  so  fascinating  to  the  young 
child,  untrammelled  by  the  hard  and  fast  rules  of  calisthenics 
or  gymnastics.  Nor  does  the  evil  end  here.  While  the  forcing 
process,  which  is  to  stimulate  the  mental  powers  far  beyond  the 
real  capacity  of  the  immature  and  growing  brain  to  receive,  is 
in  progress,  another  is  inaugurated  which  is  to  qualify,  especially 
the  female  child,  to  acquit  herself  with  distinction  when  the 
time  arrives  for  entering  the  great  world  of  society,  or,  as 
Thomas  Brown  would  style  it,  "  for  the  frivolous  work  of  pol- 


212  LIFE    OF   D.    HAYES    AGNEW,    M.D.,    LL.D. 

ished  idleness."  The  gait  and  carriage  must  be  reduced  to  pre- 
scribed rules,  the  voice  toned  down  to  a  drawl ;  the  muscular 
apparatus  of  the  face  must  be  taught  to  express  not  the  spon- 
taneous and  natural  outcome  of  feeling  which  wells  up  unbid- 
den from  the  magic  chambers  of  the  heart,  but  rather  to  pro- 
duce an  effect.  And  so  this  work  of  transformation  goes  on 
until  it  culminates  in  the  full-blown  "  society  girl."  Is  it  any 
wonder  that — under  such  a  scheme  of  education,  conducted 
tliroughout  by  a  studied  disregard  of  both  the  physical  and 
mental  constitution,  and  exercising,  as  it  does,  such  tremendous 
drafts  on  the  nervous  system — the  world  is  being  filled  with 
a  class  of  flat-breasted,  spindle-limbed  young  women,  unfitted 
for  the  varied  and  responsible  functions  of  womanhood ;  qual- 
ifications, too,  wdiich,  under  a  different  regimen  and  directed 
into  proper  channels,  would  exert  a  most  potential  influence  on 
all  the  great  social  and  moral  problems  of  the  age  1 

While  thus  plain  spoken  on  the  frivolous  methods  of  living, 
I  do  not  wish  to  be  understood  as  being  unfriendly  to  the  high- 
est cultivation  of  the  mental  and  physical  powers,  if  conducted 
on  lines  in  harmony  with  the  organization,  nor  to  any  technique 
which  may  conduce  to  personal  grace  or  elegance  of  manners, 
so  that  the  manly  or  womanly  personality  of  the  individual  be 
not  sacrificed  to  the  Molech  of  sentiment  and  sham.  Indeed, 
indifference  to  these  matters  is  inexcusable  in  either  man  or 
^voman,  as  not  only  lessening  their  influence  in  the  world,  but, 
in  many  respects,  disqualifying  them  for  the  highest  discharge 
of  the  duties  of  modern  hfe.  Valuable  as  may  be  the  unpolished 
diamond,  yet  it  is  only  after  the  wheel  of  the  lapidary  has  worn 
away  the  dull  incrustations  that  its  true  brilliancy  is  revealed, 
and  the  gem  is  fitted  to  adorn  the  brow  or  breast  of  beauty. 

In  the  further  discussion  of  my  subject,  I  may  next  notice 
the  evils  of  visceral  displacement  consequent  on  abdominal  con- 
striction. Whatever  may  be  said  in  regard  to  Greek  and 
Roman  life,  the  infinite  care  which  these  people  displayed  in 
developing  and  maintaining  the  very  best  type  of  the  human 


DR.    AGNEW    AS    A    WRITER.  213 

form  is  worthy  of  admiration  and  emulation.  The  Ionic  "  Che- 
ton,"  spoken  of  by  Attic  writers,  and  so  often  represented  by 
the  bronzes  of  Herculaneum,  while  it  would  not  exactly  satisfy 
the  modern  idea  of  dress,  was,  at  least,  free  from  the  charge  of 
interfering  with  the  contour  of  the  human  figure. 

The  painters  and  sculptors  of  those  classic  days  were 
reverent  students  of  Nature.  Their  delineations  were  true  to 
life.  Their  works  furnish  us  with  no  hour-glass  contractions 
of  the  human  body.  The  constriction  of  the  waist  operates 
injuriously  on  both  the  supra-  and  infra-  diaphragmatic  organs. 
Any  force  acting  on  the  base  of  the  thorax  and  preventing  the 
expansion  of  its  walls  concentrates  tlie  function  of  respiration, 
which  should  be  general,  on  the  apices  of  the  lungs;  and  hence, 
under  these  circumstances,  the  movements  of  breathing  are  for 
the  most  part  confined  to  the  summit  of  the  chest.  As  the  seat 
of  tuberculosis  is  generally  located  in  the  upper  part  of  the 
lungs,  may  not  the  inordinate  work  entailed  on  these  parts  by 
constriction  have  some  influence  in  hastening  such  deposits  in 
the  female  when  the  predisposition  exists] 

It  is  this  forcing  inward  of  the  costal  border  of  the  thorax 
which  causes  the  groove  on  the  anterior  surface  of  the  liver  so 
familiar  to  anatomists.  The  pressure  cannot  fail  to  interfere 
with  the  descent  of  the  diaphragm,  and  with  the  functions  of 
the  gall-bladder  and  duodenum,  and  exercises  no  small  degree 
of  influence  in  favoring  the  formation  of  gall-stones,  females 
being  peculiarly  prone  to  such  concretions.  The  extent  to  which 
the  liver  may  be  damaged  by  extreme  constriction  of  the  waist 
is  well  illustrated  by  a  case  recently  reported  in  the  British 
Medical  Journal^  in  which  a  considerable  portion  of  the  lefl  lobe 
of  the  liver  had  been  separated  from  the  right,  the  two  being 
connected  only  by  a  band  of  connective  tissue,  which  enabled 
the  operator  to  remove  the  detached  mass  without  difficulty. 

The  evil  effects  of  this  constriction  on  the  viscera  of  the 
abdomen  and  pelvis  is  most  strikingly  witnessed  in  the  embar- 
rassed portal  circulation,  in  the  different  uterine  displacements, 


214  LIFE   OF   D.    HATES    AGNETF,    M.D.,    LL.D. 

elongation  of  ligaments,  displaced  ovaries,  tubal  inflammations, 
hemorrhoids,  hernia,  and  other  morbid  conditions,  which  either 
prevent  or  disqualify  the  woman  for  the  exercise  of  the  func- 
tions of  maternity,  and  which,  in  addition  to  reflex  influence, 
entail  a  host  of  functional  disorders  reaching  into  every  avenue 
of  the  body  and  invading  both  the  mental  and  moral  constitution 
of  the  Adctim. 

So  prolific  have  these  infirmities  become  that  a  new  depart- 
ment of  surgery  has  been  organized  for  their  special  manage- 
ment. To  what,  if  not  to  social  causes,  can  be  these  morbid 
changes  of  structure  in  the  pelvic  organs,  especially  of  the  uterus 
and  its  appendages,  be  attributed]  Why  should  laceration  of 
the  cervix  uteri  be  so  common  an  accident]  Labor  is  a  natural 
process,  and  ought  not,  under  ordinary  circumstances,  to  be 
attended  by  lesion  of  uterine  tissue.  I  can  conceive  of  no  agency 
more  likely  to  induce  that  muscular  degeneration  which  predis- 
poses to  this  accident  than  the  modes  and  methods  of  modern 
living,  especially  among  the  inhabitants  of  great  cities.  Tn  the 
expression  "modern  living,"  much  is  embraced.  It  includes 
culinary  pharmacy,  overfeeding  and  overdrinking,  insufificient 
or  injudicious  exercise,  improperly  heated  apartments,  and  a 
disproportion  between  the  hours  of  exercise  and  rest. 

Contrast,  if  you  will,  the  muscles  of  the  hardy  country 
housewife,  who,  bearing  the  cares  and  responsibilities  of  a  de- 
pendent family,  bustles  about  the  livelong  day,  in-doors  and 
out-of-doors,  eats  with  a  relish  her  plain  and  simple  fare,  repairs 
at  reasonable  hours  to  bed,  sleeps  the  sleep  of  the  just,  undis- 
turbed bv  dyspeptic  night-mares,  and,  rising  with  the  golden 
dawn,  resumes  the  round  of  domestic  toil  with  a  clear  head  and 
supple  limbs;  I  say — contrast  this  type  of  a  class  with  that  of 
another, — the  woman  born  to  luxury  and  ease,  whose  capricious 
and  exacting  taste  taxes  the  arts  of  the  professional  caterer,  who 
drags  out  the  morning  hours  toying  with  some  crazy  piece  of 
embroidery  or  trashy  novel,  lunches  at  one,  rides  out  in  the 
afternoon  for  an  airing  of  two  or  three  hours,  returns  to  a  din- 


DR.    AGNEW    AS    A    WRITER.  215 

ner  of  five  or  six  courses  at  seven,  completes  tlie  evening  at  the 
opera,  the  tlieatre,  or  the  assembly,  and,  coming  home  after 
midnight,  crawls  into  bed,  weary  and  exliausted  in  mind  and 
body,  only  to  rise,  with  the  best  hours  of  the  morning  gone,  for 
another  day  of  aimless,  routine  life. 

Can  it  be  doubted  that  in  the  first  case,  with  a  digestion 
luiimpaired,  with  the  products  of  textural  change  consumed  by 
functional  activity  and  eliminated  through  the  proper  eniunc- 
tories,  the  woman  should  possess  a  vital  resistance  and  a  tone  of 
tissue  altogether  superior  to  that  of  the  other,  whose  habits  of 
living  must  necessarily  favor  their  faulty  metamorphosis? 

To  these  same  agencies  must  be  attributed  tliat  brood  of 
nervous  and  hysterical  evils  for  the  relief  of  which  the  gyne- 
cologist too  often,  I  fear,  invades  the  domain  of  womanhood 
around  which  her  whole  sexual  nature  revolves,  and  which, 
save  in  the  direst  extremity,  should  be  sacred  against  all  opera- 
tive intrusion. 

Late  marriages  constitute  another  social  evil,  the  penal 
inflictions  of  which  involve  both  sexes  alike.  Pride  and  luxury 
determine  long  engagements  or  deferred  proposals.  Marriage, 
it  is  believed,  necessarily  involves  an  establishment,  a  display, 
a  retinue  of  servitors.  The  good  old  notion  of  two  souls  being 
united  in  wedlock  for  the  purpose  of  being  mutual  helpmates, 
and  patiently  together  working  up  from  modest  beginnings  to 
affluence,  seems  to  be  entirely  at  variance  with  the  modern  idea 
of  this  relation.  In  the  meantime  the  vouno^  man  is  betraved 
into  unlawful  sources  of  gratification,  alike  destructive  to  moral 
and  physical  purity,  the  pollution  of  which  incontinence  is 
often  communicated  to  and  perpetuated  in  wife  and  offspring. 
I  would  not  dare  to  say  how  many  cases  of  this  nature  have 
been  entrusted  to  my  professional  confidence,  although  I  doubt 
not  my  experience  does  not  differ  from  that  of  many  of  my  pro- 
fessional brethren. 

It  may  be  thought  by  some  persons  that  the  subject  of  the 
foot  and  shoe  is  not  of  sufficient  dignity  to  appear  in  a  public 


/ 


216  LIFE    OF   D.    HAYES   AGNEW,    M.D'.,    LL.D. 

address.  The  Romans  and  the  Greeks  thought  differently. 
The  Hterature  of  both  people  is  full  of  reference  to  the  shoe 
worn  by  both  sexes.  So  important,  indeed,  are  the  feet  to  the 
well-being  of  the  body  that  whatever  impairs  their  usefuhiess, 
either  for  support  or  locomotion,  becomes  a  positive  calamity. 
Nothing,  scarcely,  is  less  like  the  human  foot  than  the  modern 
shoe.  Let  any  one  leave  the  impress  of  his  or  her  foot  in  the 
wet  sand  of  the  sea-shore  and  then  place  alongside  of  the 
imprint  a  fashionable  shoe ;  that  the  two  were  intended  for 
each  other  would  scarcely  strike  a  child  of  the  forest.  The 
North  American  Indian  entertains  greater  notions  about  clothing 
this  portion  of  his  body  than  does  the  civilized  denizen  of  New 
York  or  Philadelphia. 

Compare  the  moccasin  with  the  French  shoe  of  the  city 
belle.  Compare  the  aavhaT^ov  or  the  Ttepcrt^at  of  Pollux  and 
Aristophanes  with  the  same,  and  we.  shall  see  that  the  savage 
and  the  polished  Greek  alike  understood  the  value  of  sound 
feet  in  the  race  of  life.  It  is  the  imperfect  adaptation  of  the 
shoe  to  the  foot  which  constitutes  the  fruitful  source  of  tired 
ankles,  corns,  bunions,  overlapping  of  the  toes,  and  ingrowing 
nails.  Some  idea  may  be  formed  of  the  magnitude  of  the  evil 
from  the  fact  that,  of  800  patients  under  the  care  of  a  prom- 
inent chiropodist  of  Philadelphia,  the  great  majority  of  the 
defects  were  entirely  attributable  to  the  contracted  toes  and 
high  heels  of  the  slioes.  Especially  do  these  physical  in- 
cumbrances arising  from  a  blind  submission  to  social  laws 
operate  disadvantageously  to  our  fair  women  at  the  beginning 
of  the  new  dispensation,  requiring  both  muscle  and  brain,  and 
when  her  friends  propose  to  sweep  away  all  the  old  traditions 
and  claim  for  her  the  earth  with  all  its  masculine  employments. 

Games  and  amusements,  which,  in  themselves,  are  proper 
and  praiseworthy,  too  often  become  developed  into  a  craze, 
working  both  moral  and  physical  mischief  In  the  national 
game  of  base-ball  tliere  is  the  "  pitcher's  arm,"  a  condition  of 
overtaxed  function,  and  one  in  which  all  the  anatomical  ele-^ 


DR.    AGNEW    AS    A    WRITER.  217 

ments  of  the  upper  arm  are  involved.  There  is  also  the  "  tennis 
arm  "  and  the  swollen,  supersensitive  prostate  of  the  hicyclist, 
both  due  to  abuse  of  proper  popular  amusements. 

Defects  of  refraction,  or  defects  of  ^'ision,  constitute  another 
class  of  affections  fairly  attributable,  in  many  instances,  to  social 
influences.  The  number  of  children  who  may  be  seen  on  our 
streets  any  day  wearing  glasses  has  become  a  matter  of  common 
observation.  It  is  far  from  being  probable  that  the  most 
exquisite  piece  of  mechanism — the  human  eye — came  from  the 
Divine  Artificer  imperfect. 

Because  eyes  are  young,  it  does  not  follow  that  they  are 
thereby  better  fitted  to  sustain  prolonged  use.  Just  the  reverse 
is  true,  and  it  is  high  time  that  parents  and  educators  begin  to 
realize  this  fact.  The  power  of  the  eye  for  continued  use,  like 
that  of  other  organs  of  the  body,  is  one  of  gradation.  It  moves 
in  the  general  procession  and  strengthens  with  the  advance  in 
life  until  development  has  attained  its  zenith.  Not  only  so,  but 
the  eye,  being  a  part  of  the  body,  must  suffer  or  rejoice  through 
the  operation  of  general  causes.  A  bone  may  have  its  normal 
curves  changed,  a  tendon  may  slip  from  its  appointed  groove,  or 
a  blood-vessel  be  destroyed,  and  yet  very  little  disability  be 
realized ;  but  the  eye  is  made  up  of  such  extremely  delicate 
structures,  and  acts  according  to  fixed  physical  laws,  that  not 
the  slifi^htest  alteration  of  a  curve,  or  the  mobilitv  or  densitv  of 
its  media,  can  occur  wdthout  great  vitiation  of  function. 

To  exact  long  hours  of  study  from  children  of  a  tender 
age  involves  a  degree  of  functional  strain  altogether  dispro- 
portionate to  the  structural  resources  of  the  organ,  and,  by 
disturbing  the  orderly  processes  of  nutrition,  gives  rise  to 
hypermetropia,  asthenopia,  astigmatism,  and  its  companion, 
headache.  That  the  picture  is  not  too  highly  colored  or  the 
sensation  overstrained,  we  have  only  to  contrast  the  children 
born  and  reared  in  those  portions  of  the  country  not  too  much 
dominated  by  the  methods  of  modern  civilization  and  who 
rarely  demand  a  resort  to  artificial  aids  to  provide  for  abnormal- 


218  LIFE    OF   D.    HATES    AGNEW,    M.D.,    LL.D. 

ities  of  vision.  The  only  remedy  for  the  evil,  where  infantile 
scholarship  is  insisted  upon,  is  the  kindergarten,  or  object 
system, — the  most  natural  and  eifective  plan  of  impressing  the 
young  mind. 

Is  there  any  reasonable  explanation  drawn  from  sources  of 
a  social  nature  for  the  great  frequency  of  those  renal  diseases 
which  come  more  particularly  under  the  care  of  the  surgeon  as 
crystalline  deposits  and  calculi  1  For  maintaining  the  general 
health  at  the  highest  physiological  standard,  a  proper  quahty 
of  food  and  the  proper  disposal  of  tissue  waste  are  essential 
conditions.  Along  with  wealth  and  luxury  come  the  abuses 
of  the  table.  Americans  are  fast  becoming  a  nation  of  dys- 
peptics. The  country  is  so  rich  in  the  products  of  every  zone 
that  nowhere  else  in  the  world  can  you  find  such  a  variety  of 
of  foods,  animal  and  vegetable.  These  foods,  manipulated  in 
a  thousand  ways  by  the  subtle  art  of  the  professional  cook, 
almost  necessarily  betray  one  into  excess  and  also  create  the 
desire  for  wine  and  other  alcoholic  beverages  to  aid  the  stomach 
in  disposing  of  its  plethoric  supply. 

In  great  cities,  which  furnish  relatively  the  largest  number 
of  cases  of  renal  disease  affecting  pre-eminently  the  mercantile 
and  sedentary  classes,  we  find  just  the  conditions  favorable  to 
their  development.  The  competitions  of  trade  keep  the  mer- 
chants always  at  white  heat.  Time  is  golden,  and  the  street-car 
and  other  means  of  conveyance  annihilate  distance  and  the  ride 
is  substituted  for  the  needful  one.  A  hasty  lunch  at  the  most 
convenient  restaurant  satisfies  the  inner  man  until  the  business 
of  the  day  is  closed,  when,  weary  and  worn,  he  is  driven  to  his 
home  to  partake  of  a  course  dinner,  the  balance  of  the  evening 
to  be  spent  on  the  lounge  with  the  evening  paper  or  the  latest 
periodical.  To  the  literary  man,  the  fascinations  of  the  study 
and  the  library  charm  him  away  with  their  syren  voices  from 
the  fields  and  highways  until  bodily  exercise  grows  distasteful 
and  repugnant.  In  the  meantime  there  has  been  no  provision 
made  for  the  waste  or  tissue  metamorphosis  of  the  body  through 


DR.    AGNEW    AS    A    WRITER.  219 

that  great  agency,  exercise.  These  accumulate  in  the  blood. 
The  internal  eliminating  organs,  of  which  the  kidneys  are  chief, 
are  overtaxed,  and  then  follow  the  evils  of  malassimilation  and 
of  excretion,  in  the  form  of  urates  and  oxalates,  often  resulting 
in  the  formation  of  calculi. 

In  conclusion,  may  we  ever  hope  for  a  time  when  the  race 
will  realize  that  these  bodies  which  we  wear,  which  God  has  so 
highly  honored  by  His  own  incarnation,  are  sacred  temples,  to 
be  kept  in  harmony  with  recognized  physical  laws,  and  not  to 
be  made  instruments  of  mere  animal  gratification. 


CHAPTER  X. 

The  Garfield  Case. 

On  the  2d  of  July,  1881,  James  A.  Garfield,  then  Presi- 
dent of  the  United  States,  was  shot  in  the  Baltimore  and  Poto- 
mac Hallway  Station,  at  Washington,  by  Charles  J.  Guiteau. 
The  motive  of  the  assassin  was  never  fully  determined.  It  was 
discovered  subsequently,  however,  that  he  was  one  of  that  vast 
swarm  of  applicants  for  position  who  fill  Washington  at  all 
times,  demanding  or  begging  favors  of  government  officials. 
He  had  written  to  the  President  asking  for  the  Paris  consulship; 
his  application  had  been  referred,  with  thousands  of  others,  to 
the  proper  department.  Guiteau  undoubtedly  was  consumed 
with  an  overweaning  desire  to  become  notorious,  in  which 
ambition  he  was  not  restrained  by  the  possession  of  a  strongs 
moral  nature,  or  any  great  degree  of  mental  power.  With  the 
cunning  of  his  low  intellect,  he  reasoned  that  if  he  should  re- 
move the  President,  naturally  all  eyes  would  be  attracted  to 
him,  and  his  name  would  be  on  every  tongue.  There  would  be 
thrown  around  his  name  the  romance  of  a  Wilkes  Booth,  while 
he  would  be  protected  from  punishment  by  the  opposing  branch 
of  the  President's  party,  out  of  gratitude  for  placing  them  in 
powder  by  the  change. 

President  Garfield  was  on  his  way  to  a  reunion  of  his  class 
at  Williams  College ;  accompanied  by  Mr.  Blaine,  Secretary  of 
State,  and  Colonel  Rockwell,  he  was  standing  in  the  ladies' 
waiting-room  at  twenty  minutes  past  nine  on  the  morning  of 
July  2d.  The  assassin  approached  him  from  the  rear,  coming 
within  a  distance  of  six  feet,  firing  two  shots  from  a  powerful 
revolver  of  •4:2-calibre.  One  shot  went  through  the  President's 
coat-sleeve,  but  the  other  strnck  him  in  the  back,  felling  him  to 
the  ground.  He  was  carried  at  once  to  the  second  story  of  the 
station  building  and  placed  upon  a  mattress,  several  physicians 
(220) 


THE    GARFIELD    CASE.  221 

who  happened  to  be  m  the  vicmity  administering  stimulants 
to  him.^  At  the  suggestion  of  Mr.  Robert  Lincoln,  Secretary 
of  War,  Dr.  D.  Willard  Bliss  was  summoned. 

Dr.  Bliss  found  that  the  point  of  entrance  of  the  ball,  which 
was  oval  and  sharply  marked,  was  on  the  right  side,  in  the 
tenth  intercostal  space,  four  inches  from  the  median  line  of  tlie 
spine,  and  on  a  line  with  the  eleventh  rib.  A  slight  discharge 
of  blood  was  oozing  from  this  orifice,  and  had  stained  the  cloth- 
ing. Dr.  Bliss  passed  a  Nelaton  probe  through  the  tenth  inter- 
costal space,  downward  and  forward  for  a  distance  of  three  and 
one-half  inches  from  the  surface  of  the  body,  to  what  appeared 
to  be  a  cavity,  but  he  was  unable  to  detect  any  foreign  substance, 
beyond  the  rib,  to  indicate  the  presence  of  fragments  of  bone  or 
the  missile.  In  attempting  to  withdraw  the  probe  it  became  en- 
gaged between  the  fractured  fragments  and  the  end  of  tlie  rib,  and 
could  not  be  freed  until  pressure  was  made  upon  the  sternal  end 
of  the  rib.  Dr.  Bliss  then  passed  the  little  finger  of  his  left  hand, 
to  its  full  length,  into  the  wound,  which  showed  the  character  and 
extent  of  the  fracture  of  the  rib ;  but  he  was  able  only  to  reach 
a  point  on  a  line  with  the  inner  surface  of  the  rib,  where  his 
finger  came  in  contact  with  what  appeared  to  be  lacerated  tissue 
or  comparatively  firm  coagula  of  blood — probably  the  latter. 

After  withdrawing  his  finger,  Dr.  Bliss  made  an  explora- 
tion with  a  long,  flexible,  silver  probe,  which  he  suitably  curved 
before  introducing,  and  gently  passed  it  downward  and  forward, 
and  downward  and  backward,  with  a  view  of  determining 
the  course  of  the  ball,  if  it  had  been  deflected  by  contact  with 
the  rib  ;  but,  meeting  with  resistance  from  soft  parts  in  all 
directions,  Dr.  Bliss  desisted,  being  inclined  to  the  belief  that 
the  ball  had  entered  the  liver,  which,  if  true,  would  not  warrant 
further  exploration  in  that  direction. 

By  this  time  a  large  number  of  physicians  had  gathered 
in  the  room,  and  Dr.  Bliss  gave  them  a  hurried  account  of  his 

1  The  physicians  in  attendance  immediately  after  the  shooting  of  the  President  were 
Drs.  Townshend,  Purvis,  Reyburn,  Norris,  Lincoln,  Patterson,  and  J.  B.  Hamilton. 


222  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

examinations  and  expressed  the  opinion  that  no  further  explora- 
tions should  be  made  during  the  stage  of  collapse,  and  that  stim- 
ulants by  the  stomach  should  not  be  given  at  that  time,  as  the 
President  was  suffering  from  constant  nausea,  and  in  his  condi- 
tion absorption  would  not  take  place.  The  President  repeatedly 
requested  that  he  be  taken  to  the  White  House,  and,  after  a 
further  consultation  and  a  full  understanding  of  the  manner  and 
detail  of  his  transfer,  his  speedy  removal  was  agreed  upon. 

Temporary  dressings  were  applied  to  the  wound,  and  the 
President  was  placed  upon  a  stretcher,  carried  down-stairs^ 
and  placed  in  an  ambulance  in  waiting.  The  vehicle  was^ 
driven  with  great  care  to  the  White  House,  the  President  not 
experiencing  any  discomfort.  He  was  taken  to  his  room,  which 
was  known  as  the  Southwest  or  family  room  of  the  house.  On 
the  arrival  of  the  President  at  the  White  House  a  careful  ex- 
amination was  made  of  his  condition.  His  pulse  continued 
feeble,  frequent,  and  exceedingly  compressible ;  the  respiration 
was  slow  and  sighing;  his  extremities  and  the  surface  of  his 
body  were  cold ;  he  had  been  vomiting  freely ;  his  entire  body  was 
bathed  in  a  profuse  perspiration ;  his  voice  was  husky ;  he  con- 
stantly complained  of  severe  pains  in  the  limbs.  He  was  placed 
on  his  right  side,  so  as  to  make  the  wound  dependent,  to  facili- 
tate drainage,  and  keep  the  viscera  in  contact  with  the  injured 
walls,  looking  for  the  possible  adhesion  of  the  injured  parts  to 
the  peritoneum.  It  was  deemed  improper  to  remove  his  clothing 
at  this  time.  Water  was  given  in  small  quantities,  often  re- 
peated. This  was  necessitated  by  the  extreme  thirst  from  which 
the  patient  suffered.  A  hypodermatic  injection  of  ^  grain  of 
morphine  and  ^-^  grain  of  atropine  was  administered,  to  control 
the  pain  in  the  extremities  and  as  a  more  permanent  stimulant 
to  assist  reaction. 

This  was  at  10  o'clock  on  the  morning  of  July  2d.  There 
was  but  little  change  in  the  condition  of  the  patient,  either  in 
temperature,  respiration,  or  pulse,  until  11  o'clock,  when  it 
was  determined  to  repeat  the  morphine  in  a  dose  of  ^  grain. 


THE   GARFIELD    CASE.  223 

This  had  the  effect  of  modifying  the  pain  and  discomfort,  and 
the  respiration  became  more  frequent  and  easy.  The  pulse 
responded,  however,  but  feebly  to  the  stimulants.  Nausea  and 
vomiting  continued  at  intervals  of  thirty  minutes  during  the 
entire  day  and  until  7  in  the  evening,  when  it  became  less 
frequent,  being  simply  a  regurgitation  of  fluids  from  the 
stomach.  This  condition  returned  at  longer  intervals  until  6 
o'clock  the  following  morning. 

At  5.30  P.M.,  in  accordance  with  a  previous  understanding 
with  the  physicians,  the  clothing  ivas  cut  from  the  body  in  such 
a  way  as  to  prevent  any  motion  or  agitation,  and  to  permit  a 
more  successful  application  of  dry  heat  by  warm  flannels  to 
the  entire  body,  which  had  been  imperfectly  accomplished  be- 
fore. Examination  showed  a  well-defined  field  of  dullness  over 
the  region  of  the  wound,  thought  to  be  due  to  hemorrhage  from 
the  substance  of  the  liver,  along  the  supposed  track  of  the  ball, 
extending  seven  and  a  half  inches  antero-posteriorly  and  five  and 
a  half  inches  laterally.  At  the  evening  consultation,  held  July 
2d  at  7  P.M.,  the  opinion  was  expressed,  as  a  result  of  this 
examination,  that  internal  hemorrhage  had  taken  place,  and 
that,  in  consequence,  the  distinguished  patient  would  not  sur- 
vive the  night.  At  10  p.m.  the  pulse  was  158;  temperature, 
96.5°  F. ;  respiration,  35;  but  at  11.20  p.m.  the  evidences  of 
reaction  began  at  last  to  manifest  themselves.  The  pulse 
diminished  to  120;  the  temperature  and  respiration  became 
normal. 

From  this  time  till  2  p.m.  on  July  3d  the  variations  of  the 
pulse  were  comparatively  slight,  ranging  from  104  to  120,  the 
respiration  and  temperature  being  normal.  The  patient  slept 
at  short  intervals,  generally  arousing  with  an  effort  at  regurgi- 
tation of  the  contents  of  the  stomach,  but  otherwise  expressing 
a  feeling  of  comfort  and  showing  evidences  of  rest.  During  the 
night  he  seemed  to  be  refreshed,  and  was  comparatively  free 
from  pain.  There  was  no  period  up  to  this  time  that  the 
patient  was  not  perfectly  rational,  and   he   often   made  brief^ 


224:  LIFE   OF   D.    HAYES    AGNEW,    M.D.,    LL.D. 

pertinent  inquiries  as  to  the  character  of  the  wound  and  his 
condition. 

There  was  some  oozing  of  dark  venous  blood  during  the 
night,  sufficient  to  saturate  the  carbohzed  cotton,  which  was 
used  as  a  dressing,  and  stain  the  bed.  On  the  following  morn- 
ing the  hemorrhage  had  entirely  ceased,  and  the  dressings  be- 
came adherent  to  the  skin.  The  physicians  invited  by  Dr.  Bliss 
to  visit  the  bedside  were  Surgeon-General  Wales  of  the  Navy, 
Surgeon-General  Barnes  of  the  Army,  Surgeon  J.  J.  Woodward, 
Dr.  N.  S.  Lincoln,  and  Dr.  Robert  Beyburn.  At  the  consulta- 
tion held  the  morning  of  July  3d,  the  patient  was  found  Avith  a 
pulse  of  115,  with  his  temperature  and  respiration  nearly  nor- 
mal. He  was  cheerful,  gave  evidence  of  being  rested,  and 
made  definite  inquiries  regarding  his  condition  and  prospects. 
The  use  of 'morphine  hypodermatically,  in  doses  of  sufficient 
quantities  to  control  the  pain  in  the  extremities,  was  continued. 

At  this  time  the  resumption  of  all  the  normal  functions  of 
the  kidneys,  bladder,  and  intestines  showed  that  no  internal 
organ  had  been  injured.  Slight  tympanites  was  detected,  but 
there  was  no  other  evidence  of  anything,  during  the  whole 
course  of  the  case,  which  pointed  toward  the  existence  of 
peritonitis. 

Immediately  after  this  consultation,  the  subject  of  medical 
attendance  was  considered  by  the  President.  He  placed  him- 
self formally  in  Dr.  Bliss's  professional  care  at  this  time,  and 
requested  him  to  select  his  own  counsel. 

Dr.  Bliss,  realizing  the  great  responsibility  of  his  position 
and  the  necessity  of  selecting  such  medical  authorities  as  would 
universally  be  conceded  to  be  the  leaders  of  the  profession  in 
America,  decided  to  summon  Dr.  D,  Hayes  Agnew,  of  Philadel- 
phia, and  Dr.  Frank  H.  Hamilton,  of  New  York.  At  the  same 
time  Mr.  Wayne  MacVeagh,  the  Attorney-General  of  the 
administration,  had  also  urged  upon  Mrs.  Garfield  the  propriety 
of  taking  Dr.  Agnew  into  the  case. 

Dr.  Agnew  received  the  message  that  he  was  wanted,  at 


THE   GARFIELD    CASE.  225 

midnight  of  July  3d.  lie  was  at  that  time  spending  the 
summer  at  his  country  pUice,  "Wyndrifl,"  at  Haverford,  near 
Philadelphia.  Attorney-General  Wayne  MacVeagh  telegraphed 
to  Mr.  A.  J.  Cassatt,  at  Haverford  College  Station,  requesting 
him  to  determine  whether  Dr.  Agnew  would  come  at  once  to 
Washington,  and,  if  so,  to  make  arrangements  for  a  special  train. 
It  was  necessary  to  repeat  the  message  at  Philadelphia,  where  it 
was  shown  to  the  Night  Dispatcher  of  the  Philadelphia  Division 
of  the  Pennsylvania  Railroad,  who,  anticipating  the  orders  that 
he  knew  he  would  receive,  immediately  dispatched  a  special 
train  to  Haverford  College  Station.  So  quickly  was  this  done 
that  the  train  reached  the  station  before  the  message  returned 
to  the  dispatcher,  and  by  the  time  Dr.  Agnew  was  dressed  and 
ready  he  was  carried,  without  a  second's  delay,  to  Philadelphia. 
The  train  left  Gray's  Ferry,  Philadelphia,  at  1.10  a.m.,  and 
arrived  at  Washington  at  J:.01  a.m.,  making  the  ran  of  one 
hundred  and  forty  miles  in  one  hundred  and  seventy-one 
minutes,  being  the  quickest  trip  on  record,  between  Philadelphia 
and  the  Capital,  up  to  that  time.  Dr.  Frank  H.  Hamilton 
quickly  followed  from  New  York. 

The  President  had  passed  a  comparatively  comfortable 
night,  awakening  every  twenty  or  thirty  minutes,  taking  water 
or  liquid  nourishment  in  small  quantities  each  time,  and  drop- 
ping quickly  to  sleep.  The  nausea  had  subsided,  and  the  pain 
and  soreness  of  the  lower  extremities  were  controlled  by  the 
administration  of  morphine.  A  careful  review  of  the  case  from 
the  time  Dr.  Bliss  first  saw  the  President  was  given  to  his  new 
consultants,  with  the  request  that  they,  with  the  data  before 
them,  examine  the  case  thoroughly,  as  if  it  were  their  own,  and 
express  freely  their  views  of  the  character  and  gravity  oi'  the 
injury  and  the  course  of  treatment  of  the  case  up  to  that  time. 
Dr.  BUss  also  gave  them  a  detailed  account  of  the  explorations 
made  in  the  wound,  and  the  unsettled  convictions  then  held  as 
to  the  course  of  the  missile,  and  the  organs  involved  in  the 
injury. 


226  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

The  new  consultants  examined  the  case  separately  with 
great  care.  They  studied  the  data  of  the  progress  of  the  symp- 
toms for  the  first  forty-seven  hours,  and  examined  the  wound 
thoroughly.  The  more  prominent  data  upon  which  the  diagnosis 
could  be  based  were  as  follow:  The  relative  position  of  the 
assassin  to  the  President  at  the  time  of  the  shooting ;  the  direction 
of  the  ball  through  the  tissues,  so  far  as  safe  exploration  could 
determine;  the  appearance  of  severe  pains  and  hyperesthesia 
in  the  limbs,  especially  on  the  right  side,  with  their  gradual  subsi- 
dence or  modification  ;  the  repeated  unsuccessful  efforts  to  pass 
a  probe  or  flexible  instrument  more  than  half  an  inch  in  any 
direction  beyond  the  fractured  rib»  except  in  a  direction  down- 
ward, a  little  forward  and  anterior  to  the  twelfth  rib,  a  distance 
of  about  two  inches.  The  fact  was  also  considered  that  explora- 
tions had  twice  been  made  with  the  finger,  once  by  Dr.  Bliss 
soon  after  he  reached  the  injured  President,  and  subsequently 
by  Surgeon-General  AVales,  of  the  navy,  on  the  occasion  of  the 
consultation  on  the  evening  of  July  2d,  when  in  each  instance  it 
was  found  impossible  to  explore  successfully  beyond  the  inner 
border  of  the  fractured  rib.  The  consultants  did  not  under- 
estimate the  significance  of  the  profound  shock,  nor  the  unusual 
period  of  collapse  which  followed,  and  which  seemed  to  point 
to  extensive  injury  of  important  viscera.  The  hyperesthesia 
and  continued  pains,  more  marked  on  the  right  side,  pointed  to 
a  moderate  degree  of  laceration  of  nerve-trunks,  but  there  was 
no  evidence  of  injury  to  the  spinal  cord  or  its  bony  column. 

The  consultants  did  not  attempt  to  force  their  probing 
with  too  great  vigor ;  the  condition  revealed  at  the  autopsy 
showed  the  wisdom  of  this  policy.  Probing  sufficient  to  have 
gone  any  distance  into  the  wound  would  undoubtedly  have  done 
fatal  harm,  as  will  be  shown  later,  while  it  could  not  have 
revealed  by  any  possibility  the  location  of  the  ball. 

The  possible  course  of  the  ball  was  decided  to  be  in  one  of 
three  directions:  (1)  either  into  or  through  the  liver;  (2)  back- 
ward at  a  right  angle  so  as  to  involve  the  spinal  column,  or  (3) 


THE   GARFIELD   CASE.  227 

downward  behind  the  poritonenm  into  the  pelvic  cavity.  In 
regard  to  the  first  supposition,  tlie  consultants  did  not  believe 
that  the  ball  had  passed  through  the  liver,  as  had  been  surmised 
at  first  by  Dr.  Bliss.  Tlie  suggestion  that  it  had  been  deflected 
to  tlie  left  and  had  injured  the  spinal  column  was  considered, 
but  the  absence  of  paralysis  showed  that  the  spinal  cord  was 
uninjured ;  the  tingling  pains  and  hyperesthesia  were  probably 
produced  by  injury  to  some  nerve-trunks  or  were  reflex  in 
character.  The  tliird  supposition,  that  the  ball  had  been 
deflected  into  the  pelvic  cavity  behind  the  peritoneum,  seemed 
the  most  probable,  although  this  theory  was  not  accepted  as 
positive,  being  regarded  by  Dr.  Agnew  merely  as  a  possibility. 

There  was  absolutely  no  data  to  show  the  course  of  the 
ball  or  its  location  to  these  men,  whose  trained  minds  would 
have  detected  the  slightest  indications,  had  they  existed. 

The  propriety  of  making  extensive  incisions  and  dissections 
so  as  to  explore  the  fractured  ribs  and  remove  as  much  as  might 
be  necessary  to  reveal  the  true  course  of  the  ball  was  considered, 
but  the  opinion  was  held  by  all  the  physicians  that  the  favorable 
progress  of  the  President  thus  far  did  not  warrant  such  interfer- 
ence, believing  that  such  an  operation  would  seriously  complicate 
the  case  and  diminish  the  prospects  of  recovery.  The  fact,  well 
known  in  military  surgery,  that  bullets  become  enveloped  in 
cysts  of  connective  tissue  quickly,  and  remain  frequently  for 
years  in  living  tissues  without  causing  damage,  also  influenced 
somewhat  this  decision. 

On  the  evening  of  July  4th  the  pain,  hyperesthesia,  and 
vomiting  had  nearly  disappeared,  but  soreness  of  the  feet  con- 
tinued for  several  days. 

The  President's  condition  remained  so  satisfactory  that  Dr. 
Bliss  did  not  deem  it  necessary  to  call  in  the  consultants  again 
until  July  23d.  They  were  kept  informed,  however,  by  long, 
daily  telegrams,  of  the  condition  of  the  distinguished  patient. 

The  case  progressed  flivorably,  with  fluctuations,  until  Julv 
23d,  when  a  chill  occurred  at  7  o'clock  in  the  evening.     Two 


228  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

days  previous  to  this  a  pus-sac  had  been  detected  beneath  the 
skin,  extending  down  below  the  twelfth  rib  toward  the  erector 
spinse  muscle  and  underneath  the  latissimus  dorsi;  it  was  care- 
fully evacuated  by  gentle  pressure.  The  consultants  did  not  feel 
satisfied,  however,  that  this  superficial  and  limited  collection  of 
pus,  which  was  so  readily  evacuated,  was  the  principal  cause  of 
the  aggravation  of  the  symptoms  present ;  so  a  free  incision  was 
made  into  the  pus-sac,  which  afforded  a  more  direct  and  depend- 
ent channel  to  the  fractured  rib,  from  which  a  small  fragment 
of  bone  was  removed.  Pressure,  made  backward  and  upward 
upon  the  abdominal  wall,  caused  a  flow  of  peculiarly  white  and 
firm  pus. 

After  this  operation  the  improvement  was  not  as  prompt  as 
the  consultants  had  expected;  and  on  July  26th  the  opening 
between  the  ends  of  the  fractured  eleventh  rib  was  enlarged, 
and  a  small  detached  portion  was  removed.  This  facilitated 
the  discharge  of  pus,  and.  as  a  result,  a  more  uniform  condition 
of  the  symptoms  was  maintained  until  August  6th,  when  a  slight 
exacerbation  in  temperature  was  noticed,  which  continued.  It 
was  discovered  at  this  time  that  pus  had  dissected  its  v.-ay  down 
behind  the  peritoneum  into  the  right  iliac  fossa ;  this  was  cor- 
roboratory of  the  supposition  that  the  ball  had  followed  this 
course.  It  was  necessary  to  evacuate  this  channel ;  conse- 
quently, on  August  8th  the  President  was  etherized,  and  an 
operation  making  a  point  of  exit  in  the  dependent  portion  of 
this  pus-sac  was  done,  the  incision  being  carried  downward  and 
forward  through  the  skin,  the  subcutaneous  fascia,  external  and 
internal  oblique  muscles,  to  the  sinus  or  pus-channel.  It  was 
discovered  at  this  point  that  there  was  a  deeper  channel,  which 
had  not  been  exposed  by  the  operation  thus  far,  and  the  incision 
was  carried  through  the  transversalis  muscle  and  the  trans- 
versalis  fascia,  affording  a  free  opening  for  the  passage  of  all 
the  pus. 

The  President  did  fairly  well  again,  after  this  operation, 
until  August  l-ith,  when  it  was  found  necessary  to  resort  to  feed- 


THE    GARFIELD    CASE.  229 

ing  by  the  bowel  until  August  17th,  owing  to  the  nausea,  vomit- 
ing, and  general  prostration  which  appeared.  At  this  date  the 
stomach  was  quieted  gradually  and  the  enemata  were  discon- 
tinued. 

On  August  18th  a  slight  swelling  of  that  portion  of  tlie 
right  parotid  gland  which  lies  directly  in  front  of  the  ear  was 
noticed.  With  this  swelling  there  was  no  pain  or  tenderness 
on  pressure.  This  parotitis  presented  many  of  the  characteristics 
of  an  ordinary  carbuncle,  and  was  unaccompanied  by  any  other 
abscesses  in  the  adjoining  tissue.  This  swelling  went  on  until 
suppuration  was  established,  when  mental  disturbance,  vomiting, 
and  restlessness  occurred.  During  the  progress  of  this  parotitis, 
facial  paralysis  occurred,  and  continued,  with  slight  improve- 
ment, until  the  time  of  death.  AVhen  the  climax  of  suppuration 
was  reached,  a  free  discharge  of  ichorous  pus  followed,  with  a 
rapid  abatement  of  the  more  urgent  symptoms;  and  after  the 
separation  of  the  slough,  which  was  limited  in  extent,  a  cor- 
responding reparation  was  rapid  and  complete  throughout  the 
entire  suppurating  surface,  as  well  as  in  the  several  incisions 
which  had  been  previously  made  to  liberate  the  pus. 

The  question  of  malarial  complication  was  discussed  at  this 
time,  but  eliminated.  During  this  time  the  pus-channel,  which 
had  opened,  had  been  kept  free  from  accumulations  by  washing 
it  frequently  and  thoroughly  with  solutions  of  carbolic  acid  or 
permanganate  of  potassium. 

During  the  latter  part  of  August,  a  number  of  pustules  of 
suppurating  acne  appeared  in  the  armpits,  and,  later,  four  or 
five  on  the  surface  of  the  body.  They  were  superficial,  num- 
bering ten  or  twelve,  being  about  the  size  of  large  peas;  they 
were  opened  as  soon  as  suppuration  took  place,  healed  with- 
out recurrence,  and  were  believed  to  have  been  due  to  the  septic 
condition  of  the  system.  The  small  carbuncle  mentioned  in  the 
report  of  the  autopsy  was  doubtless  referable  to  the  same  cause. 
Tlie  above  were  the  only  suppurating  surfaces,  excepting  the 
incisions  made  into  the  wound,  and  four  small  superficial  bed- 


230  LIFE    OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

sores  formed  on  the  back,  which  were  observed  during  the 
President's  ilhiess. 

The  subject  of  the  removal  of  the  President  to  a  more 
healthful  locality  had  been  discussed  for  some  time ;  in  fact,  it 
had  been  considered  all  summer.  The  heat  and  oppressiveness 
of  a  Washington  summer  are  to  be  dreaded,  even  by  one  in 
perfect  health,  although  an  efficient  apparatus  had  been  intro- 
duced into  the  President's  room,  giving  an  adequate  supply  of 
cold,  dry  air.  The  subject  of  his  removal  was  urgently  presented 
at  the  consultation  of  August  25th;  but,  as  at  this  date  the 
discharge  of  pus  from  the  parotid  gland  had  not  taken  place, 
the  majority  of  physicians  present  considered  that  his  removal 
at  this  time  would  be  attended  with  very  grave  peril.  His  diet 
throughout  the  summer  had  been  of  a  thoroughly  and  scien- 
tifically practical  kind ;  it  undoubtedly  kept  the  President 
alive  under  the  most  adverse  conditions  of  continued  gastric 
disturbance. 

On  August  26th  there  was  a  discharge  of  pus  from  the 
mouth,  and  from  the  ear  through  the  auditory  canal.  It  was 
believed  that  the  pus  which  discharged  in  the  mouth  dissected  its 
way  along  the  course  of  Steno's  duct,  as  there  was  rigidity  of  the 
masseter  muscle ;  but  the  jaw  was  fixed  so  as  to  prevent  the  pos- 
sibility of  opening  the  mouth  sufficiently  for  a  satisfactory  exam- 
ination. During  this  period  the  patient  occasionally  wandered  in 
his  mind,  although,  when  his  attention  was  fixed  by  an  attendant, 
his  mental  condition  seemed  to  be  comparatively  perfect. 

An  interesting  fact  connected  with  the  inflammation  of 
the  mucous  membrane  of  the  mouth  was,  that  it  extended  by 
continuity  to  the  pharynx,  larynx,  trachea,  and  bronchi.  The 
physical  signs  developed  the  fact  that  acute  bronchial  catarrh 
had  followed.  Hypostatic  congestion  of  the  lungs  had  been 
observed  for  some  weeks  before,  more  extensive  on  the  right  side 
than  the  left,  because  of  the  President's  position  in  bed.  An 
improved  condition  appeared  when  the  pus  began  to  discharge 
from  the  parotid  gland. 


i 


t>tmSlumnmii>i''i 


Dr.  Agnew  in  1882. 


THE    GARFIELD    CASE.  231 

Consequently,  it  was  decided,  early  in  September,  that  the 
patient  was  in  a  condition  to  be  removed  to  the  sea-shore. 
The  details  of  his  journey  from  Washington  to  Elberon,  and 
the  precautions  taken  to  secure  a  safe  and  speedy  transit,  were 
perfect  in  every  particular.  Every  provision  was  made  to  meet 
any  emergency  that  might  arise  in  the  course  of  the  journey, 
even  suitable  places  along  the  line  of  the  road  being  selected 
to  which  he  could  have  been  removed  in  case  evidences  of 
exhaustion  had  appeared.  His  transfer  from  tlie  Executive 
Mansion  to  the  cars  was  made  with  the  least  possible  disturbance, 
without  accident,  and  with  perfect  satisfaction  and  comfort  to 
the  patient.  During  the  journey  his  pulse  and  temperature 
were  taken  from  time  to  time,  and  frequent  examinations  made 
to  determine  the  effects  of  the  motion  at  different  rates  of  speed. 
It  was  found  that  the  President  rested  better  when  riding  at  the 
rate  of  sixty  miles  an  hour.  During  the  last  hour  of  his  journey 
he  showed  symptoms  of  fatigue,  which  would  have  prevented  a 
longer  journey,  had  such  been  required  to  reach  his  destination. 

This  journey  of  the  wounded  President  was  unique  in  the 
literature  of  railroad  management.  At  every  station  along  the 
line  of  the  road  crowds  of  men  and  women  appeared, — the  former 
uncovered  and  with  bowed  heads,  the  latter  often  weeping.  No 
sound  of  bells  or  whistles  was  heard ;  train-men  vied  with  each 
other  in  aiding  the  physicians.  On  arriving  at  the  temporary 
track  laid  to  the  Francklyn  Cottage,  it  was  found  that  the  engine 
had  not  the  weight  and  power  sufficient  to  pull  the  train  up  the 
steep  grade ;  instantly  hundreds  of  strong  hands  laid  hold  and 
pushed  the  coaches  up  to  the  level. 

The  President  bore  the  journey  well.  It  was  the  6th  of 
September,  1881,  and  the  bracing  air  of  the  early  fall  at  the 
sea-shore  and  the  sound  of  the  waves  afforded  him  the  greatest 
delight  and  satisfaction.  The  heat  of  the  two  succeeding  days 
made  but  little  impression  on  the  distinguished  patient.  For 
eight  or  ten  days  his  general  condition  visibly  and  continuously 
improved.       The    President   was    so    much   pleased   with    his 


232  LIFE    OF    D.    HAYES   AGNEW,    M.D.,    LL.D. 

improvement  that  he  expressed  a  desire  that  the  number  of  his 
professional  attendants  should  be  reduced.  Accordingly,  only 
Drs.  Agnew,  Hamilton,  and  Bliss  remained  in  charge  of  the 
case. 

During- the  evening  of  September  15th,  however,  the  in- 
evitable change  took  place,  his  pulse  slightly  increasing,  occa- 
sionally reaching  120  during  the  night.  On  September  17th, 
at  11  A.M.,  a  severe  chill  of  half  an  hour's  duration  occurred, 
followed  by  a  sharp  rise  in  temperature.  The  mental  disturb- 
ances were  more  noticeable  during  the  febrile  rise,  but  the  stom- 
ach was  still  able  to  retain  the  nourishment  and  stimulants. 

This  chill  was  accompanied  by  agonizing  pain  over  the 
chest,  which  the  President  compared  to  the  pains  in  angina 
pectoris.  These  pains  were  subsequently  believed  to  have  been 
caused  by  the  rupture  of  the  aneurismal  sac  of  one  ot  the 
splenic  arteries,  the  coat  of  which  had  been  injured  by  the  bullet 
in  its  course.  This  attack  of  pain  was  followed  by  others  at 
intervals  of  six  to  twelve  hours,  which  were  undoubtedly  due  to 
the  progressive  dissection,  at  irregular  intervals,  of  the  blood 
into  the  surrounding  tissue,  until  finally  it  burst  into  the  ab- 
dominal cavity.  On  September  18th  another  chill  occurred, 
followed  by  a  febrile  rise.  At  8  a.m.  on  September  19th  the 
President's  pulse  was  fast  and  feeble ;  his  temperature  Avas 
108°  F.,  and  all  the  conditions  unfavorable.  In  half  an  hour 
afterward  there  was  still  another  chill,  followed  by  febrile  rise. 
At  8  P.M.  on  September  19th  the  President's  pulse  was  still  fast 
and  feeble,  temperature  being  108.8°  F.  During  the  periods 
of  chill  and  fever  he  was  more  or  less  unconscious.  At  10.10 
P.M.  the  President  sank  into  an  unconscious  and  dying  condi- 
tion, and  expired  twenty-five  minutes  later.  The  brave  and 
heroic  sufferer,  the  Nation's  patient,  for  whom  all  had  labored 
so  cheerfully  and  unceasingly,  had  passed  away. 

The  post-mortem  examination  was  made  the  following  after- 
noon at  4  o'clock.  It  was  necessary  to  determine  the  exact 
track  of  the  ball  and  the  parts  involved;  also,  to  ascertain  the 


THE    GARFIELD    CASE.  233 

immediate  cause  of  death.     The  autopsy  was  performed  by  Dr. 
D.  8.  Lamb,  assisted  by  Dr.  J.  J.  Woodward. 

Record  of  the  post-mortem  examination  of  the  body  of  President  James  A. 
Garfield^  made  September  20, 1881,  commencing  at  4-30  p.m.,  eighteen 
hours  after  death,  at  FrancJclyn  Cottage,  Elberon,  Keiv  Jersey.^ 

Belli  lid  the  right  kidney,  after  the  removal  of  that  organ  from  the 
body,  the  dilated  track  of  the  bullet  was  dissected  into.  It  was  foniid 
that  from  the  point  at  which  it  had  fractured  the  right  eleventh  rib 
(three  and  one-half  inches  to  the  right  of  the  vertebral  spine),  the  mis- 
sile had  gone  to  the  left,  oV)liquely  forward,  passing  through  the  body 
of  the  first  lumbar  vertebra  and  lodging  in  the  adipose  connective  tissue 
immediately  below  the  lower  border  of  the  pancreas,  about  two  and  one- 
half  inches  to  the  left  of  the  spinal  column,  and  behind  the  i)eritoneum. 
It  had  become  completel3'  encysted. 

The  track  of  the  bullet  between  the  point  at  which  it  had  fractured 
the  eleventh  rib  and  that  at  which  it  had  entered  the  iirst  lumbar  ver- 
tebra was  considerably  dilated,  and  the  pus  had  burrowed  downward 
through  the  adipose  tissue  behind  the  right  kidne}',  and  thence  found  its 
way  between  the  peritoneum  and  the  right  iliac  fascia,  making  a  descend- 
ing channel  which  extended  almost  to  the  groin.  The  adipose  tissue  be- 
hind the  kidney,  in  the  vicinity  of  this  descending  channel,  was  much 
thickened  and  condensed  by  inflammation.  In  the  channel,  wli'ich  was 
found  almost  free  from  pus,  lay  the  flexible  catheter  introduced  into  the 
wound  at  the  commencement  of  the  autopsy  ;  its  extremity'  was  found 
doubled  upon  itself,  immediatelj^  beneath  the  peritoneum,  reposing  upon 
the  iliac  fascia,  where  the  channel  was  dilated  into  a  pouch  of  consid- 
erable size.  This  long,  descending  channel,  now  clearly  seen  to  have 
been  caused  by  the  burrowing  of  i)us  from  the  wound,  was  supposed, 
during  life,  to  have  been  the  course  of  the  bullet. 

The  last  dorsal,  together  with  the  first  and  second  lumbar  vertebrae, 
and  the  twelfth  rib  were  then  removed  from  the  body  for  more  thorough 
examination. 

When  this  examination  was  made,  it  was  found  that  the  bullet  had 
penetrated  the  first  lumbar  vertebra  in  the  upper  part  of  the  right  side 
of  its  body.  The  aperture,  by  which  it  entered,  involved  the  interver- 
tebral cartilage  next  above,  and  was  situated  just  below  and  anterior  to 
the  intervertebral  foramen,  from  which  its  upper  margin  was  about  one- 
fourth  of  an   inch   distant      Passing  obliquelj'  to  the  left,  and  forward 

1  The  general  condition  found  at  the  autopsy  is  omitted,  only  the  portion  referable 
to  the  wound  being  copied. 


-234  LIFE   OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

through  the  upper  part  of  the  body  of  the  first  himbar  vertebra,  the 
bullet  emerged  by  an  aperture,  the  centre  of  which  was  about  one-half 
inch  to  the  left  of  the  median  line,  and  which  also  involved  the  inter- 
vertebral cartilage  next  above.  The  cancellated  tissue  of  the  body  of 
the  first  lumbar  vertebra  was  very  much  comminuted,  and  the  fragments 
somewhat  displaced.  Several  deep  fissures  extended  from  the  track  of 
the  bullet  into  the  lower  part  of  the  body  of  the  twelftli  dorsal  vertel)ra. 
Others  extended  through  the  first  lumbar  vertebra  into  tlie  intervertebral 
•cartilage  between  it  and  the  second  lumbar  vertebra.  Both  this  cartilage 
and  that  next  above  were  partly  destroyed  by  ulceration.  A  number  of 
minute  fragments  from  the  fractured  lumbar  vertebra  had  been  driven 
into  the  adjacent  soft  parts. 

It  was  further  found  that  the  right  twelfth  rib  also  was  fractured 
at  a  point  one  and  one-fourth  inches  to  the  right  of  the  transverse  pro- 
cess of  the  twelfth  dorsal  vertebra;  this  injury  had  not  been  recognized 
during  life. 

On  sawing  through  the  vertebra,  a  little  to  the  right  of  the  median 
line,  it  was  found  that  the  spinal  canal  was  not  involved  by  the  track  of 
the  ball.  Tlie  spinal  cord,  and  other  contents  of  this  portion  of  the 
spinal  canal,  presented  no  abnormal  appearances.  The  rest  of  the  spinal 
€ord  was  not  examined. 

Beyond  the  first  lumbar  vertebra  the  bullet  continued  to  go  to  the 
left,  passing  behind  the  pancreas  to  the  point  where  it  was  found.  Here 
it  was  enveloped  in  a  firm  cyst  of  connective  tissue,  which  contained, 
besides  the  ball,  a  minute  quantity  of  inspissated,  somewhat  cheesy  pus, 
which  formed  a  thin  layer  over  a  portion  of  the  surface  of  the  lead. 
There  was  also  a  black  shred  adherent  to  a  part  of  the  cyst-wall,  which 
proved,  on  microscopical  examination,  to  be  the  remains  of  a  blood-clot. 
For  about  an  inch  from  this  cyst,  the  track  of  the  ball  behind  the  pan- 
creas was  completely  obliterated  by  the  healing  process.  Thence,  as  far 
backward  as  the  body  of  the  first  lumbar  vertebra,  the  track  was  filled 
with  coagulated  blood,  which  extended  on  the  left  into  an  irregular  space 
rent  in  the  adjoining  adipose  tissue  behind  the  peritoneum  and  above  the 
pancreas.  The  blood  had  worked  its  way  to  the  left,  bursting  finally 
through  the  peritoneum  behind  the  spleen  into  the  abdominal  cavity. 
The  rending  of  the  tissues  by  the  extravasation  of  this  blood  was  un- 
doubtedly the  cause  of  the  paroxysms  of  pain  which  occurred  a  short 
time  before  death. 

This  mass  of  coagulated  blood  was  of  irregular  form,  and  nearly  as 
large  as  a  man's  fist.  It  could  be  distinctlj'^  seen  from  in  front  through 
the  peritoneum,  after  its  site  behind  the  greater  curvature  of  the 
stomach  had  been  exposed  by  the  dissectiou  of  the  greater  omentum 


THE    GARFIELD    CASE.  235 

from  the  stomneh,  and  especially  after  some  delicate  adhesions  between 
the  stomach  :uid  the  part  of  the  peritoneum  covering  the  blood-mass  had 
been  broken  down  b}^  the  fingers.  From  the  relations  of  tlie  mass,  as 
thus  seen,  it  was  believed  that  the  haemorrhage  had  proceeded  from  one 
of  the  mesenteric  arteries,  but,  as  it  was  clear  that  a  minute  dissection 
would  be  requiretl  to  determine  the  particular  branch  involved,  it  was 
agreed  that  the  infiltrated  tissues  and  the  adjoining  soft  parts  should  be 
preserved  for  subsequent  stud}'. 

On  the  examination  and  dissection,  made  in  accordance  with  this 
agreement,  it  was  found  that  the  fatal  hemorrhage  proceeded  from  a  rent, 
nearly  four-tenths  of  an  inch  long,  in  the  main  trunk  of  the  splenic 
arter}^  two  and  one-half  inches  to  the  left  of  the  coeliac  axis.  This  rent 
must  have  occurred  at  least  several  days  before  death,  since  the  everted 
€dges  in  the  slit  in  the  vessel  were  united  by  firm  adhesions  to  the  sur- 
rounding connective  tissue,  thus  forming  an  almost  continuous  wall 
bounding  the  adjoining  portion  of  the  blood-clot.  Moreover,  the  i)eriph- 
eral  portion  of  the  clot  in  this  vicinity'  was  disposed  in  prett}'  firm  con- 
centric layers.  It  was  further  found  that  the  cj'st  below  the  lower  mar- 
gin of  the  pancreas,  in  which  the  bullet  was  found,  was  situated  three 
and  one-half  inches  to  the  left  of  the  coelinc  axis. 

Besides  the  mass  of  coagulated  blood  just  described,  another,  about 
the  size  of  a  walnut,  was  found  in  the  greater  omentum,  near  the  splenic 
extremity  of  the  stomach.  The  communication,  if  an}',  between  this 
and  the  larger  hemorrhagic  mass  could  not  be  made  out. 

The  surgeons  assisting  at  the  autopsy  were  unanimously  of  the 
opinion  that,  on  reviewing  the  histor}'  of  the  case  in  connection  with  the 
autopsy,  it  is  quite  evident  that  the  different  suppurating  surfaces,  and 
especially  the  fractured,  spongy  tissue  of  the  vertebra,  furnish  a  suffi- 
cient explanation  of  the  septic  conditions  which  existed  during  life, 

(Signed)         D.  W.  Bliss, 
J.  K.  Barnes, 
J.  J.  Woodward, 
Robert  Retburx, 
D.  S.  Lamb. 

There  never  was  a  case  in  the  liistory  of  medical  literature 
^vhose  entire  course  was  followed  so  anxiously,  so  closely,  and 
so  intelligently,  by  so  many  millions  of  people.  The  surgical 
aspects  of  the  case  became  so  famiUar  to  the  millions  who 
scanned  the  daily  bulletins  and  read  the  daily  papers  that 
many  surgical  methods  and  many  technical  terms  whii^h  hitherto 


236  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

had  been  the  exclusive  property  of  the  profession,  became  per- 
fectly familiar  to  all.  Undoubtedly,  before  the  summer  was  over, 
the  public  were  able  to  discuss  the  case  from  its  purely  medical 
aspect  with  the  greatest  thoroughness  and  intelligence. 

Of  course,  with  so  many  minds  studying  the  same  subject, 
enhanced  by  the  natural  obscurity  of  the  case,  considerable  dis- 
cussion arose  as  to  the  proper  treatment.  Sensational  news- 
paper-writers, anxious  to  boom  the  circulation  of  tlieir  journals, 
attacked  the  judgment  of  the  physicians  ;  medical  men,  eager 
for  notoriety,  worked  out  hypothetical  cases  in  the  privacy  of 
their  offices,  and,  fitting  the  President's  condition  to  their  theories, 
rushed  into  print.  To  the  credit  of  the  public  and  physicians 
in  charge  of  the  case,  it  must  be  said,  however,  that  the  great 
mass  of  the  public  and  the  majority  of  newspapers  accepted  the 
treatment  as  correct,  as  it  was  outlined  in  the  daily  bulletins. 

Through  all  this  storm  of  excitement,  criticism,  doubt,  and 
responsibility,  the  little  coterie  of  physicians  in  charge  of  the 
President's  case  maintained  a  dignified  silence.  It  was  en- 
couraging to  see  that  they  were  not  driven  from  the  decision 
which  they  had  reached,  by  this  great  storm  which  raged 
throughout  the  American  world.  In  the  sober  light  of  after- 
judgment  it  was  universally  conceded,  not  only  by  the  nation 
as  a  whole,  but  by  the  better  class  of  the  press^  and  the  entire 
medical  profession,  that  the  case  had  been  perfectly  treated,  and 
that  nothing  had  been  left  undone,  either  in  the  way  of  meeting 
existing  conditions  or  anticipating  possible  contingencies. 

The  questions  to  be  discussed  in  deciding  upon  the  correct- 
ness of  the  treatment  are  as  follow : — 

1.  Was  the  wound  necessarihj  a  mortal  one  ?  This  ques- 
tion was,  of  course,  of  the  most  vital  importance,  in  which  all 

1  It  is  curious  to  note  that  in  the  thousands  of  newspaper  clippings  on  Dr.  Agnew's 
life,  published  at  the  time  of  his  death,  there  were  but  two  unfavorable  notices  found.  One 
of  these  appeared  in  a  Brooklyn  paper,  written  by  some  journalistic  genius  who  stated  that- 
he  knew  all  about  the  condition  of  the  vertebra  of  President  Garfield,  as  revealed  at  the 
autopsy,  long  before  he  died.  The  other  appeared  in  a  journal  published  in  Salt  Lake  City 
under  Mormon  management.  It  stated  that  Dr.  Agnew  put  President  Gai-field  under  a 
course  of  treatment  that  would  have  killed  a  well  man. 


THE    GARFIELD    CASE.  237 

considerations  as  to  diagnosis,  treatment,  and  the  precise  mode 
of  death  would  be,  in  comparison,  of  secondary  moment, 
although,  in  the  consideration  of  the  attending  physicians, 
these  points  were  just  as  material.  In  tlie  event  of  the  plea 
of  malpractice  being  offered  in  the  Guiteau  trial,  this  would 
have  been  the  principal  question  to  liave  been  determined,  from 
a  legal  stand-point.  In  this  connection,  the  discussion  in  the 
North  American  Review  for  December,  1881,  by  four  leading 
medical  authorities  of  this  country, — Dr.  John  Ashhurst,  Jr., 
Dr.  J.  Marion  Sims,  Dr.  John  T.  Hodgen,  and  Dr.  William  A. 
Hammond, — is  to  the  point. 

Undoubtedly,  the  strongest  arguments  on  both  sides  of  the 
case  are  presented  in  this  symposium.  The  only  one  of  the  four 
to  take  the  ground  that  the  wound  in  the  vertebra,  in  the  case  of 
President  Garfield,  was  not  necessarily  mortal  was  Dr.  William 
A.  Hammond.  Dr.  Hammond  rested  this  proposition  entirely 
on  a  few  quotations  from  surgical  literature,  from  which  he 
endeavored  to  show  that  patients  may  recover  from  gunshot 
wounds  of  the  vertebrae.  The  quotations  made  by  him  are 
garbled  in  the  extreme ;  portions  of  tlie  statements  being  quoted, 
qualifying  or  explanatory  portions  being  left  out,  and  conclu- 
sions being  reached  wholly  unwarranted  by  the  quotations 
selected.  Further,  in  such  cases  as  are  cited  no  attempt  was 
made  to  prove  their  similarity  in  any  essential  particular  to  the 
case  of  President  Garfield.  It  was  a  matter  of  surprise  to  many 
who  did  not  know  Dr.  Hammond  that  he  should  have  dared  to 
risk  the  positive  assertion  that  death  was  not  inevitable  from 
such  a  wound,  based  on  such  insufficient  and  deceptive  data. 

On  the  other  hand,  the  other  three  authorities,  Drs.  John 
Ashhurst,  Jr.,  J.  Marion  Sims,  and  John  T.  Hodgen,  agreed  that 
the  President's  wound  was  necessarily  a  mortal  one.  The  real 
status  of  the  literature  of  surgery  on  the  subject  was  fully  ex- 
pressed by  Dr.  J.  Marion  Sims,  when  he  wrote  that  "o?;;*  ichole 
medical  literature  does  not  cont((in  a  single  tcell-authenticated 
case  of  recovery  from  such  a  ivouad.^' 


238  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

2.  Did  the  position  of  the  President  and  the  assassin  at  the 
time  of  the  shooting  offer  any  clue  as  to  the  track  of  the  bullet  ? 
It  was  overlooked  by  many  critics  of  the  treatment  that  this 
point  was  carefully  considered  at  the  time  of  the  shooting  and 
subsequently.  The  fact  that  the  ball,  on  entering-  the  body, 
struck  the  eleventh  rib  and  was  deflected  at  almost  a  right  angle 
from  its  original  course,  immediately  on  entering  the  body,  to- 
gether witli  its  zigzag  course  later, — revealed  at  the  autopsy, — 
showed  that  there  was  no  satisfactory  data  to  be  obtained  from 
this  source. 

3.  Could  the  hall  have  heen  detected  and  located  hy  the 
use  of  prohes  ?  The  track  of  the  bullet  as  seen  at  the  autopsy 
showed  the  wisdom  of  the  physicians  in  their  refusal  to 
persist  in  probing.  The  ball,  after  fracturing  the  eleventh  rib, 
was  deflected  downward,  comminuting  the  twelfth  rib ;  it  then 
passed  through  the  fibres  of  the  psoas  magnus  muscle,  which 
run  longitudinally;  these  fibres  undoubtedly  closed  soon  after 
the  passage  of  the  ball,  eliminating  all  possibility  of  following 
its  course,  so  that  the  track  of  the  ball  disappeared  within 
a  short  distance  from  the  skin.  If  the  probing  had  been  per- 
sisted in,  undoubtedly  the  aorta,  the  thoracic  duct,  or  the 
vena  cava,  would  have  been  in  danger  of  being  ruptured, 
for  the  vessels  lay,  with  their  delicate  walls,  in  the  direct  course 
of  the  probe ;  such  an  accident  meant  instant  death.  If  this 
greater  danger  had  been  avoided,  the  foramen  opening  into  the 
uninjured  spinal  canal  might  have  been  entered,  with  unfor- 
tunate results.  It  would  have  been  impossible  to  have  reached 
the  opening  through  the  body  of  the  vertebra;  even  if  it  had 
been  reached,  the  ball  would  have  lain  undiscovered  on  the  other 
side  of  the  spine.  Persistent  attempts  at  probing  would  have 
killed  the  President  at  once,  without  possessing  the  slightest 
chance  of  revealing  the  position  of  the  ball.  If  the  ball  had 
been  found  it  would  have  made  no  diflerence  in  the  result,  for 
it  had  become  encysted,  as  was  expected,  and  was  doing  na 
harm. 


THE   GARFIELD    CASE.  239 

4.  Were  there  any  symptoms  wluch  j^ointed  to  the  injury  in 
the  spinal  column?  Many  readers,  confused  by  the  similarity 
of  the  words  "  spinal  cord  "  and  "spinal  column,"  imagined  that 
the  spinal  cord  had  been  injured.  On  the  contrary,  the  autopsy 
revealed  the  fact  that  it  was"  uninjured,  the  spinal  column,  or 
its  bony  support,  being  the  portion  fractured  by  the  ball  in  its 
passage.  If  the  spinal  cord  had  been  injured,  it  would  have 
been  discovered,  but  no  positive  symptoms  existed  of  the  injury 
to  the  vertebra ;  in  fact,  beyond  a  few  tingling  sensations  and 
the  hyperesthesia  felt  on  the  right  side  of  the  body  below  the 
waist,  there  were  no  nervous  symptoms  at  all.  To  have  based  a 
diagnosis  of  fracture  of  the  vertebra  on  such  data  as  this  would 
have  been  poor  surgery,  for  these  slight  symptoms  are  not  at  all 
characteristic  of  such  an  accident.  The  possibility  of  this  injury 
had  been  considered,  however,  by  the  consultants  at  their  first 
meeting,  but  there  was  a  total  absence  of  data  on  which  to  base 
such  a  belief  The  probe,  as  has  been  shown,  could  not  have  re- 
vealed its  existence.  The  vomiting  and  collapse,  which  were  ex- 
treme, are  symptoms  of  shock,  and  are  common  to  that  condition. 
Their  existence,  to  an  extreme  degree,  suggested  the  possibility 
of  injury  of  some  important  viscera,  but  all  other  traces  of  such 
a  calamity  were  absent  during  the  entire  course  of  the  case.  All 
those  persons  who  revealed  the  fact — the  majority  of  them  after 
the  autopsy — that  they  had  diagnosed  this  fracture  of  the  ver- 
tebra based  their  opinions  on  data  too  weak  to  be  anything  more 
than  mere  guesswork. 

5.  Should  an  exploratory  operation  have  been  j)e7'formed 
to  search  for  the  bullet  and  to  reveal  the  condition  of  the 
wounded  parts  ?  From  a  study  of  the  answers  to  the  previous 
questions,  it  can  be  seen  that  there  was  no  clue  as  to  the  direc- 
tion in  which  such  an  exploration  should  have  been  made,  xls 
was  believed  at  the  outset,  it  Avould  have  added  greater  peril  to 
the  case,  without  improving  in  any  way  the  prospects  of  the 
wounded  President. 

Undoubtedly,  the  fatal  issue  of  the  case  was  due  to  this 


240  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

injury  of  the  vertebra.  The  septicemia,  or  blood-poisoning, 
which  appeared  can  be  traced  to  this  source.  The  injury  of 
the  cancellated  structure  of  bone  is  peculiarly  prone  to  be  fol- 
lowed by  the  production  of  blood-poisoning.  It  was  a  matter  of 
surprise  to  .the  public  to  learn  that  such  is  the  case;  it  is  due  to 
the  fact  that  the  open  venous  sinuses  in  the  cancellated  tissue  of 
bone,  bathed  in  ichorous  pus,  are  most  favorable  conditions  for 
absorption  of  this  poison  and  the  production  of  this  state. 

There  was  no  criticism  made  at  any  time  by  any  one  as  to 
the  nursing  and  feeding  and  the  general  hygienic  treatment  of 
the  patient.  This  was  acknowledged  by  all  to  have  been 
superb,  undoubtedly  prolonging  the  President's  life  for  many 
weeks.  It  is  certain  that  no  improvement  could  have  been 
made  in  the  treatment,  liad  the  injury  to  the  vertebra  been 
known.  The  treatment  throughout  was  in  accord  with  the 
rules  of  the  strictest  antiseptic  surgery.  Dr.  Hammond  wrote  in 
the  article  quoted:  "  I  desire  to  express  my  profound  admiration 
for  the  fidelity,  devotion,  and  assiduity  displayed  by  the  attend- 
ing and  consulting  surgeons.  Rarely  has  any  man,  whether  of 
high  or  low  degree,  had  a  more  laborious  and  dutiful  body  ot 
medical  and  surgical  attendants  than  had  President  Garfield, 
and  I  believe  that  in  no  other  country  in  the  world  could  such 
entire  abnegation  of  self  as  they  exhibited  have  been  obtained 
from  physicians  and  surgeons  in  attendance  on  prince  or  poten- 
tate." Dr.  Hammond  attacked  only  the  surgical  treatment  of 
the  first  forty-eight  hours  as  not  being  in  accordance  with  sur- 
gical precepts.  This  was  before  the  consultants  were  called  in; 
but  as  they  concurred  in  the  correctness  of  this  treatment,  its 
responsibility  fell  on  them  also. 

It  was  thought  probable  that  the  bullet  had  been  deflected 
into  the  right  iliac  fossa ;  but  this  belief  was  not  held  unreserv- 
edly by  the  attending  physicians,  and  by  Dr.  Agnew  it  was 
regarded  as  a  mere  ])ossibihty.  As  to  the  course  of  the  ball,  it 
was  not  an  error  of  diagnosis,  but  simply  an  absence  of  diag- 
nosis.    Such  conditions  are  every-day  occurrences  in  surgery. 


THE    GARFIELD    CASE.  241 

As  to  the  immediate  cause  of  death,  it  was  beUeved  by  Dr. 
Hammond,  in  the  article  just  quoted,  that  it  was  due  to  heart- 
thrombus,  and  that  the  pus-sac  was  tlie  sole  cause  of  the  blood- 
poisoning.  It  was  acknowledged  by  all,  however,  excepting 
this  author,  that  the  principal  source  of  septic  infection  was  the 
wound  in  the  lumbar  vertebra,  and  that  death  was  due  to  the 
rupture  of  the  aneurismal  sac  of  the  splenic  artery,  either  from 
its  injury  by  the  bullet  in  its  course  or  from  the  extension  of 
the  process  of  inflammation  to  the  artery  from  the  traclv  of  the 
ball.  Dr.  Hammond  claimed  the  possibility  of  the  rupture  of 
the  aneurismal  sac  by  the  injection  of  the  embalmer,  overlook- 
ing the  fact,  pointed  out  to  him  by  Dr.  William  Hunt,  in  the 
NeiD  York  Medical  Record  (November  26,  1881),  that  the  blood 
in  the  abdominal  cavity  could  not  have  been  pushed  out  of  the 
splenic  artery  by  the  embalming-fluid,  for  the  reason  that  there 
is  nothing  in  arteries  whicli  can  be  pushed  out  after  death,  these 
channels  being  empty  at  this  time.  Moreover,  the  arrangement 
of  the  clot  in  concentric  layers  showed  that  the  hemorrhage 
must  have  occurred  during  life. 

These  statements  and  opinions  of  Dr.  Hammond  are  sup- 
posed to  represent  tlie  strong  side  of  criticism  as  to  the  manage- 
ment of  the  President's  case.  They  are  based  on  data  pitifully 
weak,  and  they  fall  entirely  short  of  proving  that  any  essential 
difference  in  the  mode  of  treatment  would  have  resulted  any 
more  favorably.  Dr.  Hammond  did  not  claim  that  the  ball 
could  have  been  found,  much  less  abstracted,  or  that  any  system 
of  drainage  of  the  wound  in  the  vertebra  could  have  been  es- 
tablished, thus  removing  the  principal  if  not  the  sole  cause  of 
the  blood-poisoning,  and  possibly  preventing  that  depraved  gen- 
eral condition  of  the  system  which  superinduced  the  rupture  of 
the  aneurism.  On  the  otlier  hand,  the  other  three  physicians 
quoted  above  frankly  acknowledged  as  follows :  Dr.  John  Ash- 
hurst,  Jr. — "  Looking  at  the  whole  case  from  beginning  to  end,  I 
do  not  see  that  tlie  treatment  could  have  been  altered  in  any  way 
to  the  advantage  of  the  illustrious  patient;  nothing  was  done  that 


242  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

should  have  been  omitted,  and  nothmg  was  left  undone  that 
could  possibly  have  been  of  benefit."  Dr.  J.  Marion  Sims — 
"  The  President's  surgeons  did  all  that  men  could  do,  all  that 
the  present  state  of  science  would  permit,  and  all  that  could 
have  been. done  even  if  they  had  at  first  ascertained  the  course 
and  direction  of  the  ball.  Our  whole  medical  literature  does 
not  contain  a  single  well-authenticated  case  of  recovery  from 
such  a  wound.  He  had  not  the  least  chance  of  recovery  under 
any  circumstances  or  any  treatment."  Dr.  John  T.  Hodgen — 
"  In  reviewing  the  history  of  the  case  of  President  Garfield,  I 
can  find  no  reason  for  adverse  criticism  of  any  part  of  the 
management." 

So  universally  was  the  correctness  of  the  treatment  of 
President  Garfield  conceded,  that  the  legal  counsel  defending 
the  assassin  Guiteau  did  not  attempt  to  use  this  point  in  his 
defense,  resting  instead  on  a  claim  of  insanity.  Guiteau  him- 
self, however,  alternated  between  an  expressed  belief  that  the 
doctors  had  killed  the  President  and  that  that  official  had  been 
removed  by  divine  command ;  he  was  unable,  however,  to  explain 
the  discrepancy  existing  between  these  two  beliefs.  The  first 
belief  was  brought  out  at  the  commencement  of  his  trial  in  the 
following  incident.  Colonel  Rockwell  had  been  placed  on  the 
witness-stand,  by  the  prosecution,  to  prove  the  shooting  of 
the  President.  After  a  number  of  questions  had  been  asked 
him,  the  counsel  for  Guiteau  arose,  and,  claiming  that  the  ques- 
tions asked  were  irrelevant,  said,  "  We  do  not  deny,  your  honor, 
the  killing  of  the  President."  Guiteau  immediately  sprang  to 
his  feet  and  exclaimed,  "  Yes,  we  do,  your  honor ;  we  admit 
the  shooting  of  the  President, — not  the  killing." 

The  remarkable  trial,  subsequent  conviction,  and  execution 
of  Guiteau  have  be.come  a  portion  of  American  history. 

Through  the  terrible  ordeal  and  frightful  monotony  of 
eighty  days  of  prolonged  suffering  and  of  incessant  watching, 
the  wounded  President  bore  all  with  incredible  patience  and  the 
most   Christian-like   fortitude.       He    constantlv   maintained   a 


THE   GARFIELD    CASE.  243 

cheerful  aspect ;  his  words  and  actions  were  always  courageous, 
although  undoubtedly  he  was  dee})ly  impressed  with  the  proba- 
ble issue  of  his  case.  When  he  asked  Dr.  Bliss  at  the  outset,  if 
there  was  any  chance  for  recovery,  Dr.  Bliss  rephed :  "  Mr. 
President,  your  injury  is  formidable.  In  my  judgment,  how- 
ever, you  have  a  chance  for  recovery."  The  President  replied, 
with  a  cheerful  smile :  "  Well,  Doctor,  we  will  take  that 
chance."  This  was  his  attitude  through  his  entire  illness.  In 
everything  he  aided  the  physicians  and  nurses  in  their  difficult 
work  without  murmuring  or  faltering. 

The  history  of  this  famous  case  and  the  course  of  treatment 
are  given  and  explained  with  a  moderate  degree  of  detail,  be- 
cause to  a  large  portion  of  the  American  public,  outside  of 
Philadelphia  and  its  vicinity,  it  was  the  chief  means  of  acquaint- 
anceship with  Dr.  Agnew's  name.  It  has  been  stated  that  Dr. 
Agnew's  connection  with  the  Garfield  case  was  the  circumstance 
which  made  him  famous.  In  regard  to  a  portion  of  the  laity, 
this  is  undoubtedly  true,  for  the  environments  of  a  physician's 
life  are  such  that  there  is  no  way  for  him  to  become  known 
nationally  except  by  connection  with  some  such  incident.  The 
degree  of  celebrity  attained  by  Dr.  Agnew  from  his  connection 
with  this  case  cannot  be  under-estimated.  This  was  the  begin- 
ning of  that  acquaintanceship  with  his  character  and  career 
which  have,  therefore,  become  known  until  now  there  is  prob- 
ably not  a  hamlet  in  the  United  States  in  which  a  fair  knowledge 
of  his  career  and  a  good  estimate  of  his  character  and  services 
are  not  possessed  by  the  intelligent  citizen.  His  connection  with 
this  case  was  so  indissoluble  that  it  was  seen  even  in  the  streets 
of  his  own  city,  where  his  fame  and  achievements  were  no  new 
thing;  it  was  a  common  experience  for  patients  sitting  in  his 
office  to  hear  passers-by  say  something  of  this  purport :  "  Here 
is  Dr.  Agnew's  office, — don't  you  remember;  he  was  Garfield's 
surgeon'?" 

At  the  same  time,  it  is  not  fair  to  Dr.  Agnew  to  say  that 
it  was  this  connection  which  made  him  a  famous  man.     The 


244  LIFE    OF    D.    HAYES   AGNEW,    M.D,,    LL.D. 

medical  profession  of  the  world  had  regarded  him  as  the  lead- 
ing surgical  authority  in  America  and  probably  the  most  expert 
operator  in  the  world,  long  before  he  was  consulted  by  Dr.  Bliss. 
Dr.  Bliss,  in  his  selection  of  the  President's  chief  consultant, 
simply  voiced  the  general  opinion  of  the  medical  profession. 
Certainly  there  was  no  educated  physician  who  had  not  been, 
previously,  familiar  with  Dr.  Agnew's  career  and  teaching. 

While  the  Garfield  case  made  Dr.  Agnew  better  known  to 
the  general  public,  at  the  same  time  he  would  have  been  as 
much  beloved  and  as  well  known  to  the  larger  portion  of  the 
intelligent  American  world  without  it.  That  this  is  true  is 
shown  by  the  tremendous  variety  of  locations  from  which  his 
patients  came.  It  was  a  common  experience  to  find  clustered 
in  his  waiting-room  patients  from  far-distant  points.  For  ex- 
ample, one  of  his  friends  remembers  to  have  seen,  waiting  to  see 
Dr.  Agnew  at  one  time,  a  patient  from  San  Francisco,  another 
from  New  Orleans,  and  a  third  from  Boston.  They  came  from 
everywhere,  even  as  far  as  from  India  and  different  portions 
of  Europe. 

The  strain  and  annoyance  caused  by  this  case  on  the  at- 
tending physicians  can  never  be  known.  Looking  simply  at 
one  phase  of  it,  it  is  hard  for  any  one  to  realize  the  espionage 
under  which  each  physician  rested,  and  the  constant  pressure 
brought  to  bear  by  persons  seeking  information  as  to  the  Presi- 
dent's condition.  Not  only  was  Dr.  Agnew  constantly  besieged 
by  visitors,  but  even  his  servants  were  not  exempt  from  inter- 
views. It  was  the  custom  for  Dr.  Agnew  and  Dr.  Hamilton  to 
go  alternately  to  Washington  or  to  Elberon  certain  days  in  the 
week.  Of  course,  this  had  a  bad  effect  upon  Dr.  Agnew's 
practice,  as  it  made  him  unable  to  attend  to  much  of  his  work, 
and  also  made  him  uncertain  in  his  town  visits;  and,  on 
the  other  hand,  many  patients  from  this  ca,use  came  to  him 
simply  out  of  curiosity.  His  limited  time  in  town  caused  his 
waiting-room  to  be  crowded  always.  Not  only  was  the  room 
full,  but  the  windows,  the  hall-way,  steps,  and  frequently  the 


THE   GARFIELD    CASE.  24:5 

street  in  front.  Often  some  waiting  patient,  whose  time  hung 
heavily  on  his  hands,  would  count  from  seventy  to  one  hundred 
people  waiting  to  see  Dr.  Agnew.  On  such  occasions  Dr. 
Agnew  never  hurried  over  the  patients;  he  examined  each  case 
that  presented  itself  as  carefully  as  if  it  were  the  only  one. 
This  was  always  his  custom, — he  never  hurried  a  patient  out  of 
his  office.  When  his  time  was  exhausted,  he  would  step  into 
his  waiting-room  and  say :  "I  have  seen  all  that  I  can  to-day; 
those  who  still  care  to  see  me  will  please  come  at  my  next  office 
hours." 

No  one  can  ever  know  the  terrihle,  protracted  strain  on  all 
the  physicians  in  this  case.  The  letters  received  by  Dr.  Agnew 
formed  a  part  of  this  ordeal.  Frequently  a  stack  of  letters  a 
foot  high  would  be  received  in  one  day,  telling  him  what  to  do, 
what  not  to  do,  suggesting  remedies,  threatening,  inquisitive, 
and  impudent. 

One  unpleasant  phase  of  the  illness  of  the  President  was 
the  eagerness  with  which  certain  unscrupulous  persons  used  the 
condition  of  the  President  as  a  means  to  better  their  financial 
condition.  So  alarming  was  the  condition  of  the  President  from 
the  outset,  and  so  anxious  was  the  public  to  ascertain  his  con- 
dition, that  newspapers  issued  editions  at  night.  Two  or  three 
stout-lunged  fellows  with  great  rolls  of  papers  under  their  arms 
would  start  round  some  quiet  street  in  the  small  hours  of  the 
night,  and  by  their  shoutings  would  awaken  nearly  the  entire 
block.  The  half-awake  citizen,  hearing  a  jumble  in  the  street, 
and  catching  a  fragmentary  word  here  and  there,  naturally 
imagined  that  some  fresh  calamity  had  befallen  the  nation.  He 
would  purchase  the  paper,  and  by  the  time  he  had  examined  it, 
only  to  find  that  it  contained  nothing  of  special  importance,  the 
energetic  newsboy  would  be  out  of  reach. 

When  the  Committee  sent  by  Congress  to  obtain  from  Dr. 
Agnew  his  bill  for  attending  the  President  came  to  Philadelphia 
to  his  office,  Dr.  Agnew  said  :  "  Gentlemen,  I  present  no  bill 
for  my  attendance  to  President  Garfield.     I  gave  my  services 


246  LIFE    OF   D.    HATES   AGNEW,    M.D.,    LL.D.  '   . 

freely  and  gratuitously."  He  persevered  in  his  determination 
to  present  no  bill,  despite  the  advice  and  solicitation  of  th-^ 
Committee  who  had  charge  of  the  arrangements. 

Undoubtedly  the  attendance  on  this  case,  and  the  subse- 
quent treatment  which  he  received,  killed  Dr.  Bliss.  During 
the  eighty  days  which  the  President  lived,  after  receiving  his 
injury.  Dr.  Bhss'  attention  was  unceasing.  The  strain,  both 
mental  and  physical,  which  he  endured,  so  broke  down  his 
health  that  he  was  unable  to  resume  practice  for  a  long  time 
afterward.  The  tenible  ordeal  through  which  he  had  passed, 
the  attacks  made  upon  him,  and  the  accusations  both  as  to  his 
professional  and  moral  abilities,  shattered  him  completely.  He 
found,  in  consequence,  that  his  practice  had  been  largely  scat- 
tered, and  he  realized  that  he  was  not  equal,  physically,  to  the 
effort  of  regaining  it.  In  consequence,  his  income,  which  had 
averaged  $20,000  a  year  before  his  assumption  of  the  Presi- 
dent's case,  fell  to  almost  nothing.  The  last  blow  which  he 
received  was  the  niggardly  manner  in  which  he  was  treated  by 
the  government.  His  claim  for  $25,000  for  his  attendance  on 
the  President,  which  was  a  very  modest  sum,  under  the  circum- 
stances, was  cut  down,  and  he  received  $6500.  He  never 
recovered  from  this  last  action,  which  he  regarded  in  the  light 
of  an  insult,  and  his  death  occurred  not  long  after.  Although 
Dr.  Agnew  would  present  no  bill,  his  claim  was  made  equal  to 
that  of  Dr.  Hamilton's,  $15,000,  while  each  of  the  other 
attending  physicians  put  in  a  claim  for  $10,000.  Congress 
appropriated  the  sum  of  $35,000,  with  which  to  pay  the 
expenses  of  the  case.  As  has  been  said.  Dr. .  Bliss  received 
$6500 ;  Drs.  Agnew  and  Hamilton,  each,  $5000  ;  Dr.  Beyburn, 
$4000 ;  the  nurses,  Drs.  Boynton  and  Edson,  received  $4000 
and  $3000,  respectively. 

After  paying  these  sums  to  the  physicians  in  attendance, 
the  remainder  of  the  money  which  Congress  had  voted  to  the 
physicians  was  returned  to  the  Treasury  by  the  Board  of  Audit, 
although   they   had   been   instructed   to    distribute  the  whole 


THE    GARFIELD    CASE.  247 

amount.  Of  the  coterie  of  physicians  wlio  attended  President 
Garfield,  Dr.  Robert  Reyburn  is  tlie  only  survivor.  This  expe- 
rience of  Dr.  Bliss  with  tlie  Garfield  case  is  not  an  unusual  one 
in  medicine.  It  is  a  good  commentary  on  the  value  of  publicity 
to  a  physician. 

The  position  which  Dr.  Agnew  held  in  the  Garfield  case 
was  that  of  chief  consulting  surgeon.  He  was  recognized  by 
the  patient,  by  the  attending  physicians,  and  by  the  public  as 
the  man  to  whose  judgment  the  greatest  importance  was 
attached.  His  selection  for  this  position  was  spontaneous  and 
undisputed,  and  he  performed  all  the  operations  which  were 
done,  exhibiting  his  usual  dexterity  and  skill.  It  has  been  said 
that  when  Dr.  Bliss  handed  the  keen-bladed  knife  to  Dr.  Agnew 
the  eyes  of  the  Nation  were  upon  that  blade ;  and  yet,  in  no 
way  did  the  distinguished  surgeon  show  that  there  was  any 
unusual  stress  on  his  nerves,  or  that  he  was  affected  by  the 
unusual  importance  of  the  situation. 

In  a  recent  letter  of  condolence  from  Mrs.  Garfield,  she 
places  the  following  estimate  upon  Dr.  Agnew's  services  at  the 
bedside  of  her  distinguished  husband :  "  Dr.  Agnew's  fliithful 
attendance  at  the  President's  bedside  through  his  days  of  suffer- 
in  o-  won  our  deepest  gratitude  and  our  entire  confidence  in  his 
distinguished  ability  as  physician  and  surgeon.  His  presence 
was  a  constant  source  of  encouragement  and  comfort  to  Gen- 
eral Garfield,  and  his  ever-entertaining  discourse  tided  my 
husband  over  many  dark  hours." 

Dr.  Agnew  never  took  a  hopeful  view  of  the  President's 
case.  He  was  most  eager,  of  course,  to  hope  that  a  favorable 
issue  would  follow,  but  he  never  allowed  himself  to  be  deceived 
by  delusive  beliefs.  He  knew  that  deep-seated,  undiscoverable 
mischief  was  at  work.  One  day  at  Elberon  Dr.  BHss,  in  speak- 
ing of  the  President's  case,  said  that  the  world  would  soon  see 
the  most  wonderful  cure  in  medical  history.  The  same  evening, 
in  conversation  with  Dr.  Agnew,  some  one  gave  expression  to 
the  enthusiasm  of  Dr.  Bliss  and  the  joy  the  country  would  feel 


248  LIFE    OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

at  the  rescue  of  the  stricken  President.  Dr.  Agnew  Ustened 
attentively,  and  said,  in  his  quiet  way :  "I  pray  every  hour  for 
this  consummation ;  but  when  I  first  saw  the  President  I  felt 
that  death  had  claimed  him.  I  would  be  the  happiest  man  in 
Elberon  to- believe  as  Dr.  Bhss  does.  The  President  may  live 
the  day  out,  and  possibly  to-morrow ;  but  he  cannot  live  a 
week."     Garfield  died  the  next  day. 

This  case  of  President  Garfield  made  a  difficult  and 
unpleasant  task  for  his  attending  surgeons.  There  was  appar- 
ently to  the  public  but  small  chance  to  exercise  great  diagnostic 
judgment  or  operative  skill.  The  course  laid  out  by  the  con- 
sultants required  but  a  few  operations,  which  were  only  moder- 
ately difficult  in  their  performance,  and  not  especially  danger- 
ous. This  lack  of  opportunity  for  the  performance  of  some 
brilliant  surgical  operation  by  which,  after  taking  great  risks, 
the  President  could  have  been  restored  to  health,  was  deplored 
by  many.  On  the  contrary,  no  better  illustration  exists,  in  his 
whole  career,  of  the  character  of  Dr.  Agnew  than  that,  under  the 
stress  of  outside  influence,  he  did  not  swerve  a  fraction  of  an 
inch  from  his  better  judgment  and  attempt  a  brilliant  explora- 
tory operation  instead  of  adopting  the  course  he  did.  He  did 
what  he  felt  to  be  his  duty, — what  his  judgment  dictated, — 
without  regard  to  its  eflect  on  the  outside  world.  He  had  no 
desire  to  kindle  admiration  or  create  excitement. 

The  great  importance  of  the  service  rendered  by  Dr.  Agnew 
in  the  case  of  President  Garfield  can  scarcely  be  appreciated, 
after  it  was  accomplished.  The  credit  of  this  is  due  largely  to 
Dr.  Agnew,  because,  while  all  the  surgeons  were  unanimous 
in  their  conceptions  of  the  treatment  of  the  case,  yet,  undoubt- 
edly, had  Dr.  Agnew  advocated  another  plan  of  treatment,  it 
would  have  been  followed  out.  The  President's  assassination 
threw  the  whole  country  into  a  state  of  the  greatest  excite- 
ment, alarm,  and  apprehension.  If  the  President  had  died 
at  once,  there  is  no  telling  what  might  have  happened.  Espe- 
cial apprehension  was  felt  in  regard  to  the  line  of  succession 


THE    GARFIELD    CASE.  249 

to  the  Presidency,  in  case  anything  sliould  happen  to  the  Vice- 
President. 

This  contingency  had  never  been  provided  for  by  the 
founders  of  the  government.  It  was  a  peculiarly  dangerous 
period,  especially  on  account  of  the  numerous  insane  persons 
throughout  the  country  who  are  on  the  outlook  for  such  occa- 
sions, and  who  always  come  forward  at  such  times,  producing 
the  most  calamitous  consequences.  If  tlie  President  had  died 
at  once,  or  soon  after  the  shooting,  probably  the  excitement, 
publicity,  and  apprehension  would  have  brought  forward  a 
Guiteau  for  President  Arthur.  The  President  being  kept  alive, 
all  feelings  of  uneasiness  and  resentment  passed  away.  The 
government  had  an  opportunity  to  arrange  its  workings,  and 
the  whole  country  subsided  into  a  calmer  mood.  This  work 
of  keeping  a  mortally  wounded  man  alive  for  nearly  three 
months  was  most  stupendous  in  its  accomplishment  and  in  its 
results  for  the  country  at  large. 

Moreover,  its  value  to  President  and  Mrs.  Garfield  should 
not  be  overlooked.  It  gave  opportunity  for  the  settling  of  the 
business  of  the  President  and  the  arrangement  of  his  spiritual 
affairs,  which  was  most  comforting  to  the  living  and  the  dying. 


CHAPTER  XI. 

Dr.  Agnew's  Home-Life.^ 

So  many  know  of  Agnew  the  surgeon,  and  so  few  know  of 
Agnew  the  man  !  This  was  unfortunate,  for  it  was  under  his 
own  roof-tree,  and  in  the  midst  of  his  own  little  family  that  the 
most  beautiful  side  of  his  character  was  shown.  It  was  my 
privilege  to  have  lived  with  this  good  man  for  a  period  of  fifteen 
years.  We  were  not  a  large  family ;  there  were  only  four  of 
us, — Dr.  and  Mrs.  Agnew,  and  their  two  nieces.  Miss  Ella  P. 
Irwin  and  myself  This  number  formed,  in  Dr.  Agnew's  esti- 
mation, a  perfect  family :  four  at  home,  and  in  travel  being  a 
complete  number. 

In  their  earlier  life  in  Philadelphia  Dr.  and  Mrs.  Agnew 
had  been  in  the  habit  of  spending  their  summers  in  travel,  or  in 
resting  at  some  quiet  sea-side  resort,  near  enough  to  the  city  to 
allow  him  to  go  there  daily.  For  several  years  they  had  a  cot- 
tage at  Atlantic  City,  being  among  the  first  to  realize  the  ben- 
efits and  disadvantages  of  that  city  by  the  sea. 

In  1872  Dr.  and  Mrs.  Agnew  decided  to  go  abroad;  they 
sailed  in  June  and  returned  in  September.  This  was  the  only 
time  Dr.  Agnew  ever  crossed  the  ocean.  He  was  always  hoping 
for  a  time  to  come  when  he  might  throw  off  every  care  and 
take  a  more  satisfactory  European  trip ;  for,  unfortunately,  this 
trip  was  saddened  by  the  sudden  and  serious  illness  of  Mrs. 
Agnew.  She  was  taken  sick  in  Geneva,  Switzerland,  where 
she  lay  in  a  critical  condition  for  some  time.  When  she  had 
improved  sufficiently  to  be  moved,  she  was  taken  to  Paris, 
where  Mr.  John  Russell  Young,  then  correspondent  for  the 
New  Yorh  Herald^  kindly  placed  his  home  at  her  disposal. 

While  at  Geneva,  Dr.  Agnew  performed  several  opera- 
tions ;  for  he  could  not,  even  on  a  pleasure-trip,  leave  his  work 

1  This  chapter  was  written  by  Margaret  Agnew  Adams. 

(250) 


DR.    AGNEW'S    HOME-LIFE.  251 

wholly  behind  him.  In  consequence  of  Mrs.  Agnew's  illness, 
Dr.  Agnew  was  unable  to  visit  many  of  the  European  hospitals 
or  to  form  the  acquaintance  of  the  medical  men  whom  it  would 
have  been  a  mutual  pleasure  to  have  met. 

Yet,  when  Dr.  Agnew  returned  from  Europe,  he  came 
home  with  a  much  higher  respect  for  American  medicine  and 
surgery.  He  said :  "  Here  we  feel  that  the  welfare  of  the 
patient  is  our  first  and  highest  duty.  Abroad,  especially  upon 
the  Continent,  this  seems  to  be  a  secondary  matter.  There  they 
are  more  anxious  to  find  out  what  is  the  matter  with  the 
patient,  and  look  more  eagerly  for  an  autopsy  than  for  a 
recovery." 

In  1875  they  spent  the  summer  at  Atlantic  City,  where 
Mrs.  Agnew  contracted  a  severe  attack  of  typhoid  fever,  follow- 
ing which  for  eight  months  she  hovered  between  life  and  death. 
By  the  summer  of  1876  she  had  sufficiently  recovered  to  be 
taken  to  the  country,  and  she  was  moved  to  Bryn  Mawr.  They 
had  learned  so  to  dread  the  bad  drainage  of  hotels  and  sea-side 
resorts  and  the  exposure  incident  to  travel,  that  they  determined 
to  purchase  a  permanent  country  home,  in  which  they  could 
spend  the  summer. 

Feeling  well  satisfied  with  the  purity  of  the  air  in  the 
vicinity  of  Bryn  Mawr,  and  its  nearness  to  the  city.  Dr.  Agnew, 
in  the  fall  of  1876,  purchased  a  number  of  acres  at  Haverford 
College  Station,  on  the  line  of  the  Pennsylvania  Raih'oad,  one 
mile  east  of  Bryn  Mawr. 

He  was  one  of  the  pioneer  settlers  in  this  region,  which 
has  since  become  so  popular  and  fashionable  among  rich  Phila- 
delphians.  Here  he  built  his  country  home,  "Wyndrift,"  in 
which  he  spent,  subsequently,  so  many  happy  hours.  A  por- 
tion of  his  property  he  disposed  of,  the  following  summer,  to  his 
intimate  friend,  Mr.  Crawford  Arnold. 

This  Haverford  home  was  to  him  the  resting  ground  for 
the  few  leisure  hours  which  he  took  from  his  work.  Always 
ail  extremely  early  riser,   here   he  arose  at   6   o'clock  in   the 


252  LIFE    OF   D.    HAYES   AGNEW,    M.D.,    LL.D. 

morning,  bathed,  shaved,  and  breakfasted  by  7  o'clock,  and 
walked  to  the  station,  a  distance  of  about  three  squares,  and 
took  the  7.11  a.m.  train  for  the  city;  this  enabled  him  to  be 
in  his  office  by  10  minutes  of  8  o'clock  each  morning.  In  the 
summer-time  he  had  no  afternoon  office-hour,  remaining  in 
his  office  until  half-past  11  or  12  o'clock;  then  he  ate  a  light 
lunch,  consisting  invariably  of  cream-toast,  milk,  and  a  soft- 
boiled  egg.  These  articles  of  food  constituted  his  principal 
diet,  for  he  was  always  most  abstemious  with  food  and  drink. 
Then  he  saw  the  patients  who  required  visiting  for  the  day, 
always  planning,  if  possible,  to  return  home  about  5  o'clock  in 
the  afternoon. 

He  usually  sat,  on  his  way  to  town,  with  his  friend  Dr. 
Walter  F.  Atlee,  whose  station  was  several  miles  west  of  Haver- 
ford,  thus  giving  him  greater  advantage  in  the  selection  of  a 
seat.  The  seat  which  they  generally  occupied  would  not  have 
been  considered  desirable  by  most  people ;  it  was  the  one  at  the 
extreme  front  of  the  car,  just  back  of  the  door,  but  it  suited 
them,  and,  being  conservative  men,  they  did  not  change  after 
once  having  made  their  selection.  Often  they  would  spend  the 
short  half-hour  in  conversation — sometimes  earnest,  serious  talks ; 
again,  merry  tales  and  anecdotes.  Indeed,  Dr.  Atlee  proved  to 
be  such  a  sparkling  raconteur  that  it  became  quite  the  thing  for 
us  to  look  forward  to  an  evening  dinner-hour,  when  our  dear 
doctor  would  sooner  or  later  begin,  with  a  smile  of  pleased  recol- 
lection, "Atlee  was  telling  me  to-day," — and  then  would  follow 
"Atlee's  latest." 

Often,  however,  the  thirty  minutes  were  spent  in  reading. 
Dr.  Agnew  was  never  without  a  book,  generally  a  volume  similar 
in  size  and  style  to  the  series  of  the  "Little  Classics." 

When  Dr.  Agnew  could  come  out  to  his  country  place  he 
left  behind  him  all  the  worries  and  anxieties  of  his  busy  pro- 
fessional life.  Probably  it  required  a  visit  to  Haverford  to  see 
him  in  his  pleasantest,  easiest  moods.  Here  he  dropped  all 
thought  of  hurry  or  business,  and  lost  that  reticence  which  was 


DR.    AGNEW'S    HOME-LIFE.  253 

somewhat  a  characteristic  of  liis  work,  with  tliose  with  whom 
he  was  not  fully  acquainted. 

He  made  a  most  charming  liost ;  lie  was  affahility  and 
hospitality  itself,  and  he  possessed  that  rare  faculty  of  making 
his  guest  quickly  and  thoroughly  at  home.  Many  people,  awed 
by  his  presence  and  reputation,  have  often  said  that  they  were 
afraid  to  unbend  before  him;  but  here  he  placed  himself  in  the 
mood  of  all  those  with  whom  he  came  in  contact.  He  was  a 
brilliant  conversationalist,  and  possessed  that  rare  faculty  of 
bringing  out  in  those  around  him  their  -own  ideas  and 
tlioughts.  He  was  able  to  talk  with  every  one  who  came 
to  his  house  on  their  own  daily  work  in  a  surprisingly  familiar 
way,  and  he  was  that  rarest  of  rare  beings, — a  sympathetic 
listener.  Quietly  adding  a  word  here  and  there,  even  the  most 
diffident  school-girl  was  at  ease  with  him. 

He  loved  to  entertain  his  friends.  Many  persons  imagined 
him  to  be  stiff,  dignified,  and  devoid  of  humor.  On  the  con- 
trary, while  thoroughly  dignified,  he  never  impressed  any  one, 
with  whom  he  was  fully  acquainted,  with  any  severity  of  manner, 
and  his  sense  of  humor  and  of  the  ridiculous  was  very  marked. 
He  would  see  instantly  any  ridiculous  situation  or  incident,  and 
could  tell  a  story  with  the  greatest  clearness  and  force. 

No  one  approved  of  pure  fun  or  humor  more  thoroughly 
than  Dr.  Agnew;  but  he  was  sensitively  averse  to  gossip, — 
even  so-called  innocent  gossip  he  abhorred;  and  I  have  seen  him 
look  pained  and  embarrassed  while  within  ear-shot  of  idle  chat- 
terers whom  he  could  not  rebuke.  In  his  own  family,  he  simply 
would  not  brook  anything  wliich  even  savored  of  gossip,  saying 
always,  "If  you  cannot  speak  well  of  a  person,  it  is  best  to  say 
nothing." 

When  Dr.  and  Mrs.  Agnew  built  their  country  home,  it 
was  with  the  intention  of  spending  six  months  of  the  year  there, 
continuously,  Dr.  Agnew  intending  to  take  a  week  or  two  off 
in  tlie  summer;  but  he  soon  found  that  Haverford  was  not 
the  haven  of  rest  he  had  desired,  for  his  patients  sought  him 


254  LIFE   OF    D.    HAYES   AGNEW,    M.D.,    LL.D. 

out  even  there.  So  it  naturally  came  about  that  every  summer 
Dr.  Agnew  found  it  necessary,  in  order  to  obtain  any  rest  at 
all,  to  take  a  short  outing,  lasting  regularly  from  ten  days  to 
two  weeks,  and,  although  no  one  enjoyed  traveling  more  than 
he,  he  allowed  himself  only  one  of  these  during  the  year. 
Short  as  these  trips  were,  much  pleasure  was  crowded  into 
them.  We  usually  started  on  our  little  jaunt  about  the  second 
or  third  week  of  August. 

These  outings  were  always  most  pleasant  to  us  and  most 
eagerly  looked  forward  to ;  for  at  these  times  we  had  our  dear 
doctor  all  to  ourselves,  while  at  home  his  whole  time  belonged 
almost  exclusively  to  the  ailing  public.  A  doctor's  life  is  trying 
not  to  himself  alone ;  his  whole  family  is  called  upon  to  make 
many  sacrifices.  Indeed,  a  doctor's  household  is  perhaps  more 
thoroughly  identified  with  his  work  than  that  of  any  other  pro- 
fessional man.  Of  social  life  a  successful  doctor  has  almost 
nothing.  How  many,  many  times,  when  we  have  been  all  ready 
for  a  dinner  or  reception,  messages  have  come  calling  our  doctor 
away  !  We  were  never  sure  of  a  quiet  half-hour  with  liim,  even 
at  meal-time. 

When  away  on  one  of  these  trips,  he  enjoyed  nothing 
better  than  a  good  novel.  The  class  of  stories  which  he  read 
were  such  books  as  "  Lorna  Doone,"  the  tales  of  Scott,  "  Rab 
and  His  Friends,"  "  Uncle  Remus,"  etc. ;  he  was  particularly 
fond  of  dialect  tales,  especially  such  Scotch  and  negro  stories 
as  illustrated  the  traits,  customs,  or  thoughts  of  their  heroes. 

Many  persons  at  such  times  noted  with  surprise  how  diffi- 
cult it  was  to  get  him  to  his  meals  when  he  was  immersed  in 
the  excitements  of  a  well-told  story.  One  of  the  last  novels  he 
read  was  "Kidnapped,"  by  Robert  Louis " Stevenson.  He  en- 
tered into  its  exciting  vicissitudes  with  all  the  enthusiasm  and 
delight  of  a  boy. 

It  was  always  a  great  pleasure  to  travel  with  him ;  he  had 
friends  everywhere,  and  every  one  was  anxious,  even  eager,  to 
serve  him.     Hotel  proprietors  instinctively  gave  him  the  best 


DR.    AGNEW'S    HOME-LIFE.  255 

rooms ;  even  the  porters  on  the  trains  in  some  mysterious  way 
knew  him. 

There  was  some  subtle  influence  about  him,  which  made 
even  strangers  vie  with  each  other  to  increase  his  comfort  and 
do  him  homage.  Perhaps  it  was  the  uncommon  make-up  of  the 
man ;  his  splendid  physique  and  general  ruggedness,  softened 
by  the  crown  of  soft,  white  hair,  and  the  mildness  of  very  clear 
blue  eyes.  Dr.  Agnew,  like  his  father  and  uncles  before  him, 
was  like  unto  the  sons  of  Anak  for  goodly  height  and  manly 
proportions.     He  stood  six  feet  one  inch  in  his  stockings. 

As  he  grew  older,  he  grew  more  imposing  in  appearance. 
His  hair,  which  was  always  light,  whitened  in  his  early  man- 
hood ;  in  his  early  years  he  wore  a  iull  beard,  but  later  in  life 
discarded  everything  except  a  moustache,  which  he  allowed  to 
grow  rather  long.  There  was  a  great  deal  of  character  in  his 
hands ;  they  were  strong,  white,  and  wonderfully  supple,  and 
beautifully  cared  for.  In  his  dress.  Dr.  Agnew  was  plain  to  a 
marked  degree,  generally  wearing  a  black  frock-coat,  black 
vest,  and  black,  or  sometimes  gray  trousers.  The  only  latitude 
he  allowed  himself  in  dress  was  in  the  selection  of  neck-ties. 
Although  usually  wearing  a  black  four-in-hand  tie,  the  supply 
of  which  was  always  kept  full  by  a  patient,  yet  he  sometimes 
would  appear  in  a  garnet  satin  bow-tie. 

In  the  fall  of  1886  Dr.  R.  J.  Levis  determined  to  sell  his 
residence  at  1601  Walnut  Street.  Dr.  Agnew,  who  had  lived 
at  1611  Chestnut  Street  for  almost  twenty-one  years,  and  who 
had  been  for  some  time  on  the  lookout  for  a  house  adapted  to 
the  purposes  of  a  physician,  heard  that  the  Levis  house  was  for 
sale  and  lost  no  time  in  securing  it.  This  house  was  rebuilt 
by  Dr.  Levis,  and  was  especially  planned  for  a  surgeon,  having 
its  ofiices  on  Sixteenth  Street,  entirely  separate  from  the  rest  of 
the  house  and  not  interfering  in  any  way  with  the  domestic 
arrangements.  The  house  has  frequently  been  called  the 
"  Surgeons'  House,"  for  it  was  occupied  originally  by  Dr. 
Edward  Hartshorne,  surgeon  to  the  Pennsylvania  Hospital. 


256  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

I  think  sufficient  emphasis  has  not  been  placed  upon  Dr. 
Agnevv's  magnificent  constitution,  which  enabled  him  to  perform 
the  tremendous  amount  of  work  that  he  did.  Until  within  the 
last  five  years  of  his  life,  he  was  never  known  to  have  an  ache 
nor  pain  excepting  an  occasional  attack  of  rheumatism.  How 
often,  when  some  member  of  his  family  complained  of  head- 
ache, he  would  say,  quizzically,  "  Headache,  what  is  it '?  I 
have  never  had  it  in  my  life  !  " 

He  was  one  of  the  most  pains-taking,  tireless  workers  that 
ever  lived,  toiling  steadily  and  patiently  from  early  morning 
until  far  into  the  night.  He  really  seemed  to  find  recreation  in 
work,  and  after  doing  the  work  of  three  ordinary  men  during  the 
day — work  of  the  most  difficult,  delicate,  and  nerve-trying  char- 
acter— he  would  come  home  in  the  evening  and  go  to  his  office 
to  write  with  all  the  freshness  and  zest  of  a  boy. 

His  freshness  and  enthusiasm  made  him  seem  always  young. 
He  never  gave  the  effect  of  being  old,  and,  compared  with 
many  who  were  no  older  tlian  himself,  he  seemed  very  youthful 
in  his  ways  and  thoughts.  This  was  due  partly  to  the  fact  that 
he  adapted  himself  quickly  and  thoroughly  to  any  improvements 
in  modern  life  as  easily  as  he  did  to  those  in  medicine.  While 
he  loved  and  revered  the  good  old  customs  of  by-gone  days,  he 
did  not  cling  blindly  to  old  traditions.  As  he  said  himself:  "  I 
am  not  one  of  those  who  believe  that  the  old  is  always  better 
than  the  new;  that  we  should  always  liold  to  the  traditions  and 
methods  of  the  past.  The  past  has  gone  into  history,  and  can 
only  be  useful  to  us  in  so  far  as  it  will  serve  to  illuminate  the 
present  and  the  future." 

A  i^ropos  of  this  youthful  effect  upon  his  intimate  friends 
and  relatives,  I  well  remember  my  intense  indignation  when,  as 
a  young  girl,  I  was  asked  tlie  name  of  tlie  "  old  white-haired 
gentleman  who  sat  so  far  front  in  the  Second  Church."  White- 
haired,  to  be  sure  ;   but  old — never  ! 

Dr.  Agnew's  belief  in  his  abihty  as  a  worker  in  any  field 
was  always  of  the  humblest  character.     He  never  trusted  in 


DR.    AGNEW'S    HOME-LIFE.  257 

his  own  powers,  but  always  before  an  operation  asked  for  divine 
guidance  during-  its  performance.  He  carried  tlie  same  Inimble 
opinion  into  his  churcli-hfe.  He  was  chosen  four  times  to  the 
eldership  in  his  church,  but  each  time  he  declined  the  call 
because  he  deemed  himself  unworthy  for  tliis  sacred  office. 

Trained  from  childhood  to  the  strictest  observance  of  the 
Lord's  day.  Dr.  xlgnew  rigidly  upheld  all  the  old  customs  in 
his  own  home.  Sunday-morning  breakfast  was,  if  anything, 
earlier  than  that  of  the  other  mornings  of  tlie  week.  After  a 
chapter  in  the  Bible  and  a  prayer  for  di^•ine  guidance  through 
the  day,  the  family  separated,  to  meet  again  in  a  few  hours  at 
church.  Service  over,  we  walked  quietly  home  and  sat  down 
to  a  plain  dinner,  for  l)r.  Agnew  was  strongly  opposed  to  "  first- 
day  feasts."  After  dinner  followed  a  happy  home-hour,  in 
which  the  sermon  of  the  morning  was  discussed,  questions  in 
the  catechism  were  asked  and  explained,  and  favorite  hymns 
were  sung.  At  2.30  we  separated  again,  the  doctor  going 
to  visit  his  patients  and  the  younger  ones  going  to  Sunday- 
school.  At  6  o'clock  came  supper,  after  which  another  chapter 
from  the  Bible  and  a  prayer  for  divine  protection  during  tbe 
hours  of  the  night,  and  the  doctor  would  spend  the  inter- 
vening time  belbre  evening  service  in  reading  the  Bible  or 
his  flxvorite  "  Life  of  Guthrie  " ;  9.30  o'clock  found  the  house 
closed  for  the  night. 

As  a  child,  how  I  dreaded  those  Sundays  !  No  Sunday- 
school  books,  no  Avalks,  no  gazing  out  of  the  front  windo\v  at 
the  altogether  too  attractive  dresses  of  other  little  girls  !  How 
hard,  how  tiresomely  hard  it  all  seemed !  As  I  grew  older, 
however,  those  dear  Sundays  at  home  became  to  me  the  sweetest 
days  of  all  the  days  of  my  young  womanhood ;  and  I  shall 
always  hold  them  in  blessed  memory. 

Dr.  Agnew  never  had  a  Sunday  office-hour,^  and  never, 

1  He  observed  the  custom,  however,  of  seeing  patients  in  his  office  at  5  o'clock 
Sunday  afternoon,  whose  condition  demanded  attention,  but  who  were  not  sick  enough  to 
be  confined  to  the  house. 

17 


258  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

unless  kept  away  by  some  ailing  one,  missed  the  morning  and 
evening  service  at  the  church  he  so  dearly  loved. 

He  was  particularly  attracted  to  clergymen,  esteeming  it 
the  greatest  honor  and  privilege  to  entertain  them.  I  can  see 
him  now^the  dear  old  man — with  face  all  aglow,  sitting  on  the 
porch  of  his  country  home,  in  close  converse  with  his  dear 
friends  Macintosh  and  Hoge.  These  men  were  to  his  later  years 
what  Beadle  had  been  to  his  younger  manhood.  What  de- 
light he  took  in  them  !  What  joy  it  was  to  him  to  entertain 
them  !  In  the  days  he  spent  with  them,  it  seemed  as  though 
his  heart  were  kindled  afresh  with  the  fires  of  youth.  And  with 
what  glee  would  he  listen  to  their  anecdotes,  and,  in  his  quiet 
way,  add  boyish  reminiscences  of  his  own  ! 

He  was  extraordinarily  well  acquainted  with  theology,  and 
could  argue  on  a  doctrine  or  discuss  a  theological  movement 
with  the  greatest  vigor  and  comprehensiveness.  He  undoubtedly 
would  have  made  a  good  minister.  He  could  talk  beautifully 
and  simply  on  religious  subjects,  on  which  he  felt  a  great 
courtesy  toward  the  feelings  and  opinions  of  all.  He  would 
frequently  allow  points  to  pass  in  which  he  did  not  believe, 
simply  from  a  desire  not  to  wound  the  feelings  of  his  guest. 

There  was  always  a  great  source  of  affinity  between  mem- 
bers of  other  religious  beliefs  and  Dr.  Agnew.  Although  he 
was  of  the  strictest  Calvin  Presbyterian  belief,  yet  he  was  very 
tolerant  of  other  beliefs,  and  formed  many  of  his  friends  among 
people  who  were  most  diverse  to  him  in  religious  opinions. 
Roman  Catholics  seemed  particularly  attracted  to  him,  especially 
members  of  the  priesthood  and  sisterhood.  It  was  no  uncommon 
sight  to  see  four  or  six  nuns  sitting  in  his  w^aiting-room.  He 
expressed  great  sympathy  and  admiration  for  tlie  works  of  these 
orders,  and  under  no  circumstances  would  he  charge  them  for 
his  services  any  more  than  he  did  the  Protestant  clergy.  In 
return,  they  appreciated  his  kindness  and  skill  and  made  him 
the  recipient  of  many  beautiful  presents. 

The  number  of  presents  which  Dr.  Agnew  received  was 


DR.    AGNEW'S    HOME-LIFE.  259 

simply  tremendous.  They  consisted  of  everything  imaginable : 
handsome  carriages,  thorough-bred  horses,  registered  cattle, 
watches,  canes,  barrels  of  oysters,  terrapin, — in  fact,  everything 
fancy  could  suggest.  He  smoked  the  very  best  brands  of  cigars 
and  cigarettes,  which  were  always  kept  in  stock  by  his  admirers. 
Even  his  ice-house  each  winter  was  filled  with  particularly  pure 
ice  sent  by  a  patient  from  northern  Pennsylvania.  Without 
going  more  into  detail,  this  will  give  an  idea  of  the  infinite 
variety  of  presents  received  by  him. 

It  always  annoyed  and  displeased  Dr.  Agnew  to  be  compli- 
mented for  his  work  or  praised  for  his  skill;  he  had  no  craving 
for  such  return,  and  he  always  tried  to  avoid  it.  At  the  time 
of  the  semi-centennial  celebrations  of  his  entrance  into  the  medi- 
cal profession,  there  were  so  many  laudatory  expressions  poured 
forth  on  him  by  the  medical  profession,  his  patients,  by  the 
newspapers,  and  from  the  pulpit  that  he  said  it  made  him  un- 
easy. He  feared  that  the  good  people  of  Philadelphia  would 
want  to  banish  him,  impelled  by  the  same  reason  that  the 
Athenians  ostracized  Aristides — because  they  had  grown  weary 
of  hearing  him  called  "the  Just." 

Doctors  are  only  human,  and  they  have  instinctively  their 
likes  and  dislikes  among  their  patients;  they  live  in  a  little 
world  of  their  own,  of  which  they  are  the  centre,  and  in  which 
they  come  into  the  most  confidential  relations  with  those  who  have 
intrusted  to  them  their  health.  This  relation  is  often  even  more 
confidential  than  that  which  exists  between  pastor  and  people. 

The  responsibility  which  a  true  physician  feels  toward  his 
patients  is  something  which  bears  heavily  upon  him,  and  yet, 
at  the  same  time,  brings  him  the  keenest  pleasure.  Dr.  Agnew 
always  regarded  his  duty  to  his  patients  as  a  most  sacred  trust, 
allowing  nothing  to  interrupt  its  performance. 

While  Dr.  Agnew  did  not  allow  himself  to  be  biased  by  his 
personal  feelings,  still,  like  other  physicians,  he  had  his  attrac- 
tions and  repulsions  among  his  patients.  No  one  among  them, 
however,  ever  knew  when  he  experienced  the  latter   feeUng; 


260  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

on  the  contrary,  they  rather  regarded  themselves  as  the  favored 
ones.  Fortunately  they  were  few  in  number,  for  Dr.  Agnew 
was  as  fond  of  the  majority  of  his  patients  as  they  were  of  him. 
Once  in  a  while,  however,  he  would  meet  with  a  patient  who 
tried  his  forbearance  to  the  utmost.  Every  practising  phy- 
sician has  some  such  patients,  the  very  sight  of  whom  tires  him 
as  soon  as  they  enter  his  office-door. 

These  patients  have  usually  been  seriously  afflicted  with 
some  ailment  at  one  time,  from  which  they  have  recovered,  but 
they  have  been  unable  to  rid  their  minds  of  the  delusion  that 
they  are  still  suffering  I'rom  disease.  Dr.  Agnew,  by  his  promi- 
nent position  and  well-known  forbearance,  attracted  to  him  from 
time  to  time  a  number  of  these  hypochondriac  cases.  He  knew 
too  well  beforehand  the  repetition  of  the  long,  unnecessary  re- 
cital of  their  peculiar  woes. 

During  his  illness  of  a  year  ago,  there  was  one  patient  who 
called  on  him  regularly  every  day  to  see  if  he  were  well  enough 
to  attend  to  her  wants.  Her  all-consuming  concentration  on 
her  own  sorrows  had  dimmed  her  anxiety  for  his  condition,  ex- 
cepting the  desire  that  she  wanted  him  to  get  well  enough  to 
attend  to  her.  She  impressed  upon  those  whom  she  met  the 
great  devotion  which  Dr.  Agnew  felt  for  her,  and  said:  "If  he 
knew  I  were  down-stairs,  sick  as  he  is,  he  would  get  up  and 
come  down  and  see  me."  So  persistent  was  she  in  her  daily 
calls  that  when  the  doctor  finally  recovered  sufficiently  to  see  a 
few  selected  cases  occasionally,  her  name,  without  his  knowl- 
edge, was  put  among  the  first  on  the  list.  As  soon  as  his  eye 
caught  this  fact  he  exclaimed,  "I  would,  give  a  hundred  dol- 
lars not  to  see  that  chatter-box.  Write  and  tell  her  that  I  can- 
not see  her."  When  he  was  expostulated  with  that  she  would 
know  that  he  was  seeing  other  patients,  he  said,  "Well,  tell 
her  I  have  gone  to  Europe  to  be  gone  indefinitely ;  or  make  any 
other  excuse,  I  don't  care  what."  The  sequel  proved,  however, 
that,  in  his  kindness  of  heart  and  forbearance,  she  had  the  privi- 
lege of  seeing  him  among  the  first,  after  all. 


DR.    AGNEW'S    HOME-LIFE.  261 

Dr.  Agnew,  like  most  public  men,  was  a  target  for  all  sorts 
of  cranks  seeking  advancement  or  self-advertisement.  Just  as 
his  connection  with  tlie  Garfield  case  brought  him  hundn^ds  of 
letters,  giving  him  all  sorts  of  presumptuous  advice,  so  in  liis 
own  case  in  his  final  illness.  His  mail  at  this  time  was  filled 
with  all  sorts  of  communications  telling  him  how  he  should  be 
treated. 

How  tender  and  beautiful  was  liis  love  for  his  semi-invalid 
wife  !  Always  extremely  delicate,  her  life  was  saved  many  times 
by  his  matchless  skill  and  unsleeping  care.  During  one  of  the 
serious  illnesses  of  Mrs.  Agnew's  life,  such  was  his  devotion  to 
her  that  for  over  three  months  he  never  went  to  bed  nor  caught 
more  than  a  few  momentary  snatches  of  sleep.  It  was  his 
terrible  expenditure  of  medical  skill  and  nursing  which  brought 
her  back  to  life  many  times,  after  she  had  laid  at  death's  door 
for  many  months.  The  devotion  of  these  married  lovers  for  a 
period  of  fifty-one  years  was  such  as  to  call  forth  the  admiration 
of  all  who  saw  them  together ;  and  yet,  with  the  curious  irony 
of  fate,  she,  who  had  depended  upon  him  almost  for  existence 
itself,  outlived  all  his  splendid  vitality. 

In  the  bigness  of  his  heart.  Dr.  Agnew  found  room  also 
for  the  rest  of  his  little  family.  How  gently  and  kindly  we 
were  treated  !     How  many  pleasures  he  gave  us  ! 

A  more  uncomplaining,  easily  satisfied  man  than  Dr.  Ag- 
new never  lived ;  never  depressed,  but  always  cheerful,  with  a 
pleasant  word  and  smile  for  every  one,  and  a  kindly  courtesy 
which  extended  to  the  youngest  member  of  his  household  and 
the  humblest  servant,  small  wonder  it  was  that  we  should 
vie  with  each  other  in  our  attentions  to  him.  Nothing  but  the 
best  was  good  enough  for  him,  and  in  return  how  we  treasured 
his  words  and  looks  of  thanks ! 

In  all  the  years  which  I  spent  with  him,  although  he  was 
grieved  and  hurt  many  times,  never  once  did  an  angry  word 
escape  his  lips.  How  marvelously  he  forebore  to  visit  us  with 
his  righteous  indii>-nation  when  we  so  richlv  deserved  it ! 


262  LIFE    OF   D.    HAYES    AGNEW,    M.D.,    LL.D. 

I  will  give  two  little  instances  of  his  forbearance :  In  the 
fall  of  1880  I  was  intrusted  with  a  large  roll  of  manuscript  of 
his  work  on  surgery.  This  represented  the  work  of  years.  I 
was  to  bring  it  from  his  office,  1611  Chestnut  Street,  to  Hav- 
erford.  Qn  the  way  out  I  made  several  stops,  and  by  the  time 
I  reached  Haverford  I  became  painfully  aware  that  the  manu- 
script was  not  with  me.  I  went  in  fear  and  trembling  and  made 
known  my  loss.  Not  a  hasty  word  did  he  utter.  He  simply 
looked  at  me,  and  said  "  That  was  the  work  of  years."  My 
feelings  can  be  better  imagined  than  described.  A  thousand 
scoldings  would  have  been  as  nothing  compared  to  that  gentle 
reproof  He  proved  that  he  could  bear  the  loss  of  the  work  of 
years,  like  Sir  Isaac  Newton,  with  equanimity.  Telegrams  were 
sent  in  all  directions ;  the  depot  and  the  car  in  which  I  rode  to 
Haverford  were  thoroughly  searched,  but  the  manuscript  could 
not  be  found.  The  next  day,  half  dead  with  grief  and  anxiety,  I 
went  to  the  city  determined  to  get  that  manuscript.  At  the  first 
place  to  which  I  went  I  found  the  roll,  just  where  I  had,  with 
childish  heedlessness,  put  it  the  day  before. 

In  the  summer  of  1881,  during  President  Garfield's  illness. 
Dr.  Agnew  was  waylaid  by  reporters  from  papers  all  over  the 
country.  Our  house  and  grounds  were  in  a  state  of  siege, 
while  a  group  of  reporters  always  clustered  about  the  station  at 
the  hours  at  which  Dr.  Agnew  was  expected  to  come  from  the 
city.  At  the  end  of  a  month  we  were  mildly  indignant ;  at  the 
end  of  six  weeks  we  were  desperate.  One  night  a  dapper  little 
reporter  came  to  get  a  correct  account  of  the  President's  con- 
dition. He  left  liis  hat  and  stick  in  a  dark  corner  of  the  porch. 
Knowing  Dr.  Agnew 's  thorough  dislike  of  interviews,  as  a 
childish  revenge  we  collected  a  few  pins  and  placed  them  in  the 
hat  of  the  "knight  of  the  pencil,"  wliere  they  would  be  most 
effective.  We  then  retired  behind  a  bow-window  and  awaited 
results.  We  had  not  lon<>-  to  wait,  for  Dr.  Agiiew  was  brief  in 
Ills  interviews.  The  reporter  bowed  himself  out  and  then 
placed  his  hat  firmly  on  his  head ;  but  he  quickly  took  it  off 


DR.    AGNEW'S    HOME-LIFE.  263 

and  said  something  energetically  under  his  breath.  The  next 
day  wc  had  forgotten  all  about  it,  but  the  unfortunate  reporter 
evidently  had  not,  for  half  a  column  of  the  first  page  of  his  paper, 
commencing  in  great  head-lines,  expressed  in  a  humorous  style 
his  appreciation  of  the  trick.  On  account  of  the  tremendous 
publicity  given  to  it,  I  felt,  in  my  childish  mind,  that  I  had  dis- 
graced not  only  myself,  but  my  dear  uncle,  and  I  trembled  to 
meet  him  ;  but  when  I  finally  mustered  up  courage  to  *see  him 
he  laughed,  and  referred  to  it  subsequently  as  a  good  joke. 

Dr.  Agnew  was  often  urged  to  write  an  autobiography; 
he  was  frequently  told  by  relatives  and  friends  that  the  story 
of  his  life,  as  told  by  himself,  with  his  own  description  of  his 
struggles,  ambitions  and  successes,  would  be  wonderfully  inter- 
esting and  absorbing,  as  well  as  the  greatest  encouragement  to 
younger  men  in  the  profession.  Dr.  Agnew,  however,  could 
never  be  induced  to  undertake  this  task,  under^•aluing  the  prob- 
able interest  of  the  world  in  the  details  of  his  life. 

He  grew  fonder  of  poetry  as  he  grew  older,  and  nothing 
pleased  him  more  than  to  listen  to  the  reading  or  recitation  of 
some  poetical  selection.  He  was  also  very  fond  of  hymns, 
especially  those  of  Charles  Wesley.  After  his  death,  the  fol- 
lowing verse  was  found  between  the  leaves  of  his  favorite  Bible, 
and  was,  probably,  one  of  the  last  things  he  had  copied  and 
kept.  This  hymn  must  have  seemed  to  him,  in  his  weakened 
state,  most  applicable  to  himself;  it  certainly  voiced  his  feelings, 
— the  first  natural  fear  of  death  overcome  by  the  thought  of  an 
eternity  made  beautiful  and  blessed  by  the  Master  he  had  so 
long  and  faithfully  served.  This  hymn  had  been  written  by 
the  good  and  pious  Wesley  as  he  was  dying: — 

"  In  age  and  feebleness  extreme 
Who  shall  a  helpless  worm  redeem  ? 
Jesus,  my  only  hope  thou  art, 
Strength  to  my  failing  flesh  and  heart ; 
Oh  1  could  I  catch  a  smile  from  thee, 
Then  drop  into  eternity." 


264  LIFE    OF   D.    HAYES    AGNEW,    M.D.,    LL.D. 

Dr.  Agnew  was  the  humblest,  the  most  consistent  Christian 
I  have  ever  known.  Of  all  his  kindness,  generosity,  goodness, 
and  purity  the  world  will  never  fully  know.  His  earnest  life, 
unswerving  piety,  and  truly  Christ-like  efforts  to  help  the  needy 
and  afflicted  brought  their  reward  ;  for  when  the  summons  came, 
"  Good  and  faithful  servant,  enter  thou  into  the  joy  of  thy  Lord," 
the  white  head  and  gentle  face  of  this  grand  old  saint  upon 
earth  was  suddenly  beatified  with  a  light  of  such  clear  shining 
that  heaven  and  earth  seemed  very  near.  Can  we  doubt,  with 
this  manifestation  to  our  earthly  eyes,  that  the  heavenly  welcome 
and  crown  were  wanting'? 


CHAPTER  XII. 

Dr.  Agneav's  Later  Life. 

Dr.  Agnew's  later  life  did  not  differ  in  its  details  and 
methods  from  the  work  of  the  years  that  preceded  it.  He  had 
not  changed  as  he  grew  older ;  he  remained  the  same  mild, 
unaggressive,  hard-working  surgeon  He  rarely  showed  his 
strengtli.  There  are  many  workers  in  different  fields  who  use 
at  all  times  all  the  power  and  influence  Avhich  they  possess,  but 
Dr.  Agnew  was  not  one  of  these.  His  only  exhibition  of  his 
influence  was  in  his  efforts  to  forward  the  position  and  standing 
of  his  friends  and  students. 

He  never  refused  to  aid  a  former  student,  and  manv  a  phv- 
sician  to-day  can  recall  some  deed  or  letter  of  Dr.  As-new  which 
has  opened  new  fields  or  made  paths  easier  for  himself. 
This  interest  in  his  brother-workers  was  one  reason  why  Dr. 
Agnew  became  the  idol  of  his  professional  brethren.  A  single 
instance  of  it  is  shown  in  the  following  incident,  which  repeated 
itself  innumerably  in  his  career.  The  circumstance  is  told  by 
the  physician  to  whom  it  occurred : — 

"Twenty  years  ago,  when  a  young  man  just  pushing  my 
way  into  practice  in  my  native  place,  a  very  sad  case  came 
into  my  hands  from  some  very  much  older  men.  Worried 
very  much  indeed  about  it,  and  sorely  in  the  dark  how  to 
avoid  a  renewal  of  the  failures  that  liad  met  my  predeces- 
sors in  the  case,  I  called  one  evening  at  Dr.  Agnew's  old  home 
on  Chestnut  Street,  and,  although  it  was  long  after  office 
hours,  he  received  me,  and  listened  attentively  to  my  list  of 
troubles. 

"  Then,  beginning  at  the  bottom  of  my  case,  he  unraveled 
the  whole  thread,  showing  me  where  the  failures  were  long- 
before  they  seemed  failures,  and  sent  me  away  not  only  master 
of  my  case,  but  kindlv  assured  of  his  interest  in  my  success^ 

(265) 


^66  LIFE   OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

and  with  an  appointment  to  see  him  again  in  a  few  weeks,  that  I 
might  report  to  him  the  history  of  my  success. 

"  With  the  remembrance  of  that  circumstance  in  my  mind, 
I  have  always  felt  that  a  large  portion  of  the  success  which  has 
come  to  me  here  was  owing  to  the  advice  given  me  by  Dr.  Ag- 
new,  which  made  me  successful  where  others  had  failed,  and 
brought  a  young  M.D.  into  the  prominence  which  gave  him  the 
opportunity  of  earning  his  position." 

During  these  later  years  of  his  life  Dr.  Agnew  became 
more  active  in  society  life,  being  elected  president  of  a  number 
of  societies  of  which  he  had  been  a  member ;  so  that  he  became 
more  prominent  than  he  had  been  in  his  earlier  years  in  this 
branch  of  work. 

Dr.  Agnew  never  was  an  office-seeker,  and  never  wished 
to  be  one  ;  the  minutiae,  the  intrigues,  the  wire-pulling,  and  tact 
which  are  necessary  for  successful  society  work  are  just  as  well 
marked  in  medical  politics  as  in  other  forms,  but  they  never 
fascinated  him.  He  was  too  busily  engaged  in  the  practice  of 
liis  profession  to  turn  aside  for  the  honors  and  emoluments  of 
such  work.  When  any  position  was  offered  to  him  of  trust  or 
honor  he  accepted  it  gratefully,  as  a  manifestation  of  the  wishes 
of  his  friends,  but  he  was  not  a  man  who  cared  to  organize 
societies  or  carry  out  their  routine. 

At  the  same  time  he  was  honored  by  being  elected  to  the 
presidency  of  every  medical  organization  of  w^hich  he  remained 
a  member.  The  first  medical  society  which  he  joined  was  one 
in  which  he  had  been  instrumental  in  organizing, — The  Lancas- 
ter County  Medical  Society;  while  in  the  country  he  had  joined 
with  a  number  of  fellow-practitioners  in  the  formation  of  this 
influential  body  of  medical  workers.  The  following  letter  in 
this  connection  explains  itself: — 

Lancaster,  February  21,  1889. 

My  Dear  Doctor  :  On  the  morning  of  the  14th  clay  of  Februaiy  (St. 
Valentine),  of  the  year  1844,  twentj- -three  physicians,  then  residents  of 
ihe  city  and  count}',  assembled  in  an  u})per  room,  third  floor,  of  Krampf's 
building,  corner  of  North  Queen  and  Orange  Streets,  in  the  city  of  Lan- 


DR.    AGNEW'S    LATER    LIFE.  267 

caster,  for  the   purpose  of  organizing   tlie   Lancaster  City  and   County 
Medical  Society. 

If  memory  carries  you  back  to  the  time  stated,  do  you  remember 
being  present  on  that  occasion  and  talking  part  in  the  proceedings?  The 
record  marlcs  your  presence. 

Tlie  Society  lias  just  passed  its  forty-fiftli  anniversar}-,  and  I  am 
selected  to  write  brietlj'  and  congratulate  you  with  m3'self  that  of  these 
twenty -three  physicians  there  are  but  two  survivors  (Drs.  Agnew  and 
Ehler.)  If  your  general  health  is  good  and  physical  activity  alike  good, 
you  are  up  to  my  standard.  I  perform  the  active  duties  of.  my  pro- 
fession as  of  yore.  I  am  free  of  pains  and  aches,  sleep  well,  have  a  good 
ajipetite,  eat  all  the  good  things  that  come  m}-  wa}-,  and  do  not  refuse  a 
glass  of  "  champy.  "  to  wash  the  cobwebs  from  the  fnuces.  If  3'ou  have 
a  fondness  for  old  things,  I  send  list  of  original  twenty-three  as  they 
appear  on  the  minutes  of  Society. 

With  kind  regards,  ver}-  truly  3'ours, 

J.  Aug.  Ehler. 

To  D.  Hayes  Agnew,  M.D.,  Phila 

On  his  advent  in  Philadelphia,  the  first  society  to  which 
Dr.  Agnew  was  elected  was  the  Philadelphia  County  Medical 
Society,  in  1858.  It  will  be  seen  that  he  lived  in  Philadelphia 
ten  years  before  he  became  a  member  of  this  great  society.  This 
action  on  his  part  is  a  sufficient  commentary  of  his  position 
toward  societies  at  the  time.  He  was  rewarded  for  his  long 
service  in  the  society  by  his  election  as  president  of  this  influ- 
ential body  in  1872. 

In  1859,  one  year  after  his  election  to  the  County  Medical 
Society,  he  was  made  a  member  of  the  College  of  Pliysicians, — 
the  oldest  and  one  of  the  most  distinguished  medical  associations 
in  this  country.  After  a  membership  in  this  society  for  a  period 
of  thirty  years,  he  was  made  the  thirteenth  president,  February 
6,  1889.  He  was  the  third  surgeon  to  receive  this  honor  in  the 
history  of  its  existence,  the  first  surgeon  being  William  Shippen, 
Avho  was  made  president  in  1805,  succeeding  John  Redman, 
who  had  been  the  first  president  for  sixteen  years,  while  the 
second  had  been  Thomas  Hewson,  in  1835. 

Dr.  Agnew,  while  at  the  head  of  this  august  body,  accord- 


268  LIFE    OF    D.    HAYES    AGXEW,    M.D.,    LL.D. 

ino-  to  the  traditions  of  the  society,  dehvered  three  annual  ad- 
dresses, — December  4,  1889;  December  3,  1890;  and  December 
2,  1891,  at  which  latter  date  he  retired  from  the  presidency. 
This  last  address  was  remarl^able,  as  being  the  last  one  which 
he  delivered  in  any  official  capacity.  He  was  elected  a  member 
of  the  Medical  Society  of  the  State  of  Pennsylvania  in  1870, 
and  he  was  invited  at  the  twenty-seventh  annual  session  of 
the  society,  held  in  Philadelphia  in  May  and  June,  1876,  to 
deliver  "The  Address  on  Surgery."  He  made  this  report  of  the 
progress  in  surgery  for  the  year  one  of  his  clear,  characteristic 
papers.  At  tlie  twenty-ninth  session  of  the  society,  held  in 
Pittsburgh,  in  May,  1878,  Dr.  Agnew  delivered  the  President's 
address,  taking  as  his  subject,  "  Errors  of  Diagnosis."  He  had 
been  elected  President  of  the  Society  the  year  before,  at  the 
meeting  held  in  Harrisburg,  June  14,  1877. 

He  was  elected  a  Fellow  of  the  American  Surgical  Associa- 
tion in  1882;  this  society  had  been  recently  founded,  in  1880, 
by  the  late  Professor  Samuel  D.  Gross.  Dr.  Agnew  was  elected 
President  of  this  association  May  14,  1887.  His  impromptu 
remarks  on  being  elected  President  were  considered  so  excellent 
by  the  members  of  the  society,  at  the  time,  that  they  were  in- 
serted in  the  preface  to  the  volume  of  that  year's  Transactions. 
He  spoke  extemporaneously  as  follows: — 

"  I  confess  that  this  announcement  is  to  me  one  of  regret  as  well 
as  of  surprise  and  pleasure;  regi'et  because  when  I  look  over  this  dis- 
tinguished body  of  men — of  representative  men — I  see  many  who  would 
discharge  the  duties  of  this  office  with  more  dignity-  and  more  efficienc}^ 
than  I  shall  be  able  to  do.  I  have  never  been  an  office-seeker,  and  never 
wish  to  be  one.  I  experience  also  a  feeling  of  pleasure,  because  it  is  no 
small  honor  to  preside  ovei*  a  body  of  distinguished  men  like  yourselves. 
I  accept  tlie  office  not  so  mucli  for  the  lionor  it  confers,  but  because  it 
comes  to  me  unsolicited,  and  conveys  to  me  the  good  wishes  and  good 
feeling  of  a  body  of  men  whom  1  love." 

On  September  20,  1888,  he  delivered  his  address  as  Presi- 
dent of  this  association,  taking  as  his  subject  "  The  Relation 


DK.    AGNEW'S    LATER    LIFE.  269 

of  Social  Life  to  Surgical  Disease."^  At  the  meeting  of  tlie 
society,  held  September  20,  1891,  at  Washington,  D.  C,  he 
delivered  the  opening  address,  taking  as  his  sul)ject  "  The 
Present  Status  of  Brain  Surgery."  Although  this  was  tlie  last 
paper  tliat  he  prepared,  he  displayed  in  it  even  more  than  his 
usual  care  and  brilliancy  in  deducing  conclusions  IVom  the  data 
of  which  he  treated.  One  of  the  most  distinguished  surgeons 
present  at  the  meeting  said,  on  hearing  this  paper  read :  "  These 
are  revolutionary  times,  and  it  is  to  me  a  great  satisfaction  to 
hear  the  present  Nestor  of  American  surgery  take  such  an  ad- 
vanced position  in  favor  of  operation  in  every  case  of  depressed 
fracture,  with  symptoms  or  without  symptoms." 

At  the  Congress  of  American  Physicians  and  Surgeons, 
held  at  Washington,  D.  C,  in  September,  1888,  Dr.  Agnew%  as 
President  of  the  American  Surgical  Association,  was  First  Vice- 
President,  ex-officio,  of  the  Congress.  On  the  fourth  day  of  its 
meeting,  Thursday,  September  20th,  at  the  convention  of  the 
delegates  in  the  hall  of  the  National  INIuseum,  to  listen  to  the 
address  of  the  President  on  "  Medical  Museums,"  Dr.  Agnew 
presided. 

To  render  social  intercourse  amono-  medical  men  more 
frequent  and  at  the  same  time  to  diffuse  among  them  profes- 
sional knowledge  of  the  day,  certain  well-known  physicians 
formed  clubs,  wliicli  met  one  evening  every  week  at  the  resi- 
dence of  each  member  in  rotation.  The  entertaining  member 
invited  other  physicians  not  belonging  to  the  club,  to  tlie  num- 
ber of  twenty  or  more.  The  refection  given  was  limited  to  tea, 
coffee,  bread  and  butter,  and  cakes,  and  the  conversation  was 
usually  on  professional  subjects. 

The  Monday-Evening  C'lub  was  probably  the  oldest  among 
tliese.  It  included  such  men  as  Drs.  Franklin  Bache,  Henrv 
Bond,  Isaac  Hays,  Hugh  L.  Hodge,  Samuel  Jackson,  Charles 
D.  Meigs,  George  B.  Wood,  and  Francis  D.  Condie.  Next  in 
seniority  was  the  Friday-Evening  Chib,  among  whose  members 

^  See  payc  207. 


270  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

were  Drs.  Robert  Bridges,  Joseph  Carson,  George  Fox,  W.  W, 
Gerhard,  Caspar  Morris,  and  Geo.  W.  Norris.  The  "Social 
Medical,"  or  Thursday-Evening  Club,  was  a  still  later  organiza- 
tion. Its  members  were  Drs.  D.  Hayes  Agnew,  John  B.  Brin- 
ton,  Edward  Hartshorne,  Samuel  Lewis,  J.  H.  B.  McClellan, 
J.  Forsyth  Meigs,  John  Neill,  Edward  A,  Page,  William  Burd 
Page,  Wilham  Pepper,  E,.  A.  F.  Penrose,  B.  Howard  Rand, 
Lewis  Rodman,  Robert  E.  Rogers,  AY.  S.  W.  Ruschenbergery 
Francis  G.  Smith,  Alfred  Stille,  and  Ellersley  Wallace, — in  all 
nineteen,  of  whom  five  are  living.  This  list  constituted  the 
club  for  1873-74. 

The  Social  Surgical  Club  was  started  in  1877,  as  a  medium 
for  different  surgeons  of  the  city  to  meet  occasionally  for  mutual 
improvement  scientifically  and  acquaintanceship  socially.  The 
first  meeting  of  the  club  was  held  in  the  office  of  Dr.  John  H. 
Packard,  to  whose  exertions  the  existence  of  the  club  was 
chiefly  due.  It  was  the  original  intention  of  the  incorporators 
of  the  club  to  invite  one  or  two  surgeons  from  each  hospital  in 
the  city  to  join,  each  member  bringing  cases  for  mutual  study, 
reading  papers,  and  carrying  on  discussions  on  medical  subjects. 
The  refreshments  were  to  be  limited  to  something  very  mild, 
such  as  beer  and  pretzels.  Under  these  conditions  the  society 
continued  to  meet  for  some  time.  Its  oriijinal  members  were 
Drs.  Agnew,  Brinton,  S.  AV.  Gross,  Hunt,  Levis,  Morton, 
Maury,  Reed,  Packard,  and  Mears, — the  membership  being 
limited  to  ten.  In  1879,  on  the  death  of  Dr.  Maury,  Dr.  S. 
D.  Gross  was  elected  to  the  A-acant  place.  After  the  admission 
of  this  last  distinguished  surgeon,  no  new  members  have  been 
admitted  to  the  "  Surgical  Club,"  as  it  is  familiarly  called. 

By  this  time  the  social  side  of  the  society  had  become  so 
pronounced  that  the  medical  features  sank  into  insignificance. 
The  cost  of  the  dinner  gradually  increased,  and  the  menu  be- 
came correspondingly  more  elaborate ;  still,  in  the  matter  of 
beverages,  only  beer  and  sherry  were  allowed.  Tradition  reports 
that  only  once  was  this  rule  broken  and  champagne  indulged  in. 


DR.    AGNEW'S    LATER    LIFE.  271 

At  the  suggestion  of  the  elder  Gross,  soon  after  his  admis- 
sion to  membership,  the  scientific  and  social  features,  which  had 
long  been  estranged,  were  totally  divorced  in  1879.  The  so- 
ciety continued  to  meet  and  retain  the  social  features,  inviting 
distinguished  visitors  who  chanced  to  be  in  the  city  to  its  din- 
ners. There  are  now  but  three  living  members  of  the  club, 
Drs.  Brinton  and  Packard  having  resigned,  Drs.  Agnew,  Levis, 
Maury,  Reed,  and  the  two  Grosses  being  dead. 

The  Academy  of  Surgery  was  started  to  revive  the  lagging 
medical  features  of  this  surgical  club.  The  Academy  was 
founded  April  21,  1879,  and  incorporated  December  27,  1879. 
Dr.  Agnew  was  one  of  the  founders,  and  in  January,  1880, 
was  elected  the  first  Vice-President.  Its  first  President  was  the 
gentleman  who  was  responsible  for  its  existence,  Dr.  S.  D.  Gross. 
In  October,  1884,  Dr.  Agnew  was  elected  to  the  presidency;  this 
post  he  retained  until  January,  1891,  when  he  resigned,  being- 
succeeded  by  Dr.  William  Hunt. 

Dr.  Agnew  delivered  the  annual  oration  before  the  Academy 
in  1882,  his  subject  being  "The  Life  and  Writings  of  Baron 
Larrey."  He  was  always  active  in  its  w^ork,  and  the  minute- 
book  contains  many  references  to  his  contributions  to  the  pro- 
ceedings of  the  Academy. 

Among  the  societies  of  which  Dr.  Agnew  was  a  member, 
none  gave  him  more  sincere  pleasure  than  the  little  under- 
graduate society  named  in  his  honor.  It  was  not  merely  the 
fact  that  it  was  named  in  his  honor  that  made  it  dear  to  him, 
but  more  because  he  was  peculiarly  fond  of  medical  students 
and  solicitous  for  their  welfare.  His  relations  with  his  students 
were  always  like  that  of  a  father  to  his  sons.  He  had  the 
happy  faculty  of  impressing  upon  his  scholars  the  fact  that 
he  took  a  personal  interest  in  each  one.  This  interest  was 
genuine  and  unaffected.  He  always  did  everything  in  his 
power  to  further  the  advancement  of  those  who  had  studied 
under  him. 

This  Agnew  Surgical  Society  was  founded  in  the  winter 


272  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

of  1887-88,  by  a  coterie  of  students  who  intended  to  devote  as 
much  time  as  possible  to  the  study  of  surgical  matters.  In 
order  to  accomplish  this,  it  was  the  intention  of  the  society  to 
invite  authorities  in  different  branches  of  medical  work  to 
lecture  before  them,  in  addition  to  the  preparation  of  papers  by 
individual  members.  This  kind  of  work  had  been  done  before 
by  other  medical  societies,  to  a  certain  extent ;  but  it  was  car- 
ried out  more  fully  and  more  comprehensively  by  the  Agnew 
Society.  Of  course,  the  founding  of  such  a  society,  with  three 
well-grown,  active  societies  in  opposition,  was  at  first  somewhat 
of  a  difficult  matter ;  but  the  name  of  i\.gnew  is  one  to  conjure 
with,  and  in  less  than  three  months  the  new  society  took  a 
foremost  position  in  undergraduate  life. 

It  started  with  a  course  of  brilliant  lectures  by  leading 
authorities ;  it  did  much  original  work,  but  particularly  in  its 
banquets  was  it  happy.  It  accomplished  in  its  first  year  what 
had  never  been  done  before  by  medical  undergraduate  societies, 
— that  is,  gathering  together  nearly  the  entire  Faculty  at  its  first 
annual  banquet.  These  banquets  undoubtedly  were  a  great 
feature  in  the  life  of  the  undergraduate  who  was  fortunate 
enough  to  be  a  member.  The  opportunity  to  come  in  close 
contact  with  the  Faculty, — especially  with  Dr.  Agnew, — the 
stimulus,  the  inspiration,  and  the  pathos  of  the  occasion,  made 
it  such  an  event  that  it  was  not  very  quickly  forgotten  by  its 
participants.     Dr.  Agnew  was  president  ex-officlo  of  this  society. 

On  February  21,  1891,  at  the  annual  banquet  for  that 
year,  Dr.  Agnew  presented  to  this  society  a  "loving  cup,"  from 
which  each  year  each  member  was  to  pledge  his  renewal  of 
good  fellowship.  On  one  side  is  the  Agnew  coat  of  arms,  on 
the  other  the  motto  "Sapientia  cum  latitia." 

Hawthorne  has  said,  somewhere,  that  there  are  chasms 
between  men  which  can  never  be  thoroughly  bridged  over;  that 
there  can  never  be  that  thorougli  interplay  of  feelings,  thoughts, 
and  emotions  as  exists  between  man  and  woman  or  among 
women.     The  nearest  approach  to  the  removal  of  this  isolation 


Dr.  Agnew  in  1884. 


DR.    AGNEW'S    LATER    LIFE.  273 

existed,  undoubtedly,  in  this  little  Agnew  Surgical  Society,  be- 
tween Dr.  Agnew  and  his  students. 

Another  society  of  which  Dr.  Agnew  was  a  member,  but 
which  was  not  medical  in  its  nature,  was  the  Wistar  Associa- 
tion, which  gave  the  famous  "Wistar  Parties."  This  Associa- 
tion, wdiicli  had  ceased  to  exist  in  1863-64  on  account  of  the 
political  excitement  which  was  developed  at  its  meetings,  w^as 
re-established  in  1886  by  Dr.  Casper  Wister,  one  of  Dr.  Agnew 's 
most  intimate  friends.  This  organization  was  called,  later,  "The 
Saturday-Night  Club."  These  meetings  were  held  on  Saturday 
evening,  beginning  at  9  o'clock,  and  each  member  was  entitled 
to  invite  a  certain  number  of  outside  guests  to  them.  They 
formed  gatherings  remarkable  for  their  social  and  intellectual 
attractions. 

Dr.  Casper  Wistar,  the  former  Professor  of  Anatomy  at  the 
University  of  Pennsylvania,  w^as  the  originator  of  the  "  Wistar 
Parties."  He  w\t,s  in  the  habit  of  receiving  his  friends  and 
scientific  strangers  at  his  house  on  Sunday  evenings,  and  upon 
his  death,  in  1818,  a  social  circle  was  formed  among  the  mem- 
bers of  the  Philosophical  Society,  to  which  was  given  the  name 
of  "  Wistar  Parties."  The  meetings  were  held  subsequently  on 
Saturday  evenings,  continuing  until  1863-64. 

Dr.  Agnew  was  also  a  member  of  the  medical  fraternity 
A  M  n  a,  being  elected  in  1891. 

Dr.  Agnew  rightfull}-  believed  that,  to  succeed  in  medicine, 
every  energy  and  every  tliought  must  be  concentrated  by  a 
physician  on  his  life-work,  hence  he  did  not  seek  outside  work 
or  positions ;  yet  he  held  a  few  positions  of  honor  and  trust,  not 
of  a  medical  character,  which  came  to  him  at  different  times. 
He  was  appointed  a  Manager  of  the  House  of  Pefuge  by  the 
Judges  of  the  Courts  of  Common  Pleas  of  Pliiladelj)hia  in  1859. 
He  was  at  the  time  of  his  death  by  far  tlie  oldest  member  of 
the  Board,  so  much  so  that  none  of  the  present  members  have 
personal  knowledge  of  the  condition  of  affairs  when  he  was 
appointed.     They  all  have  a  tradition,  however,  that  he  worked 


274  LIFE    OF    D.    HAYES    AGNEVT,    M.D.,    LL.D. 

great  changes  in  the  sanitary  department,  which  subject  was 
very  httle  understood  by  the  pubhc  at  that  time.  As  an  ex- 
ample of  this  reformation,  at  the  time  he  became  manager  it 
was  customary  to  have  the  towels  used  in  common  by  the  inmates, 
and,  in  consequence,  a  large  part  of  the  time,  many  of  the  chil- 
dren suffered  with  sore  eyes.  At  Dr.  Agnew's  suggestion  this 
was  altered,  so  that  each  inmate  was  given  his  or  her  own 
personal  towel.  So  much  information  is  given  in  the  resolution 
adopted  by  the  Board  of  Managers,  of  his  relation  to  this  insti- 
tution, in  reference  to  Dr.  Agnew,  after  his  death,  that  it  is 
quoted  in  full : — 

"  Dr.  Agnew  has  been  a  member  of  this  Boai'd  of  Managers  for  the 
past  thirty-three  j^ears,  always  manifesting  a  deep  interest  in  the  admin- 
istration of  the  institution  and  the  welfare  of  the  children.  Ready  at  all 
times  to  advise  upon  the  sanitary  and  hj-gienio  problems  frequently 
arising  in  the  administration  of  so  large  an  undertaking,  his  counsel  has 
been  invariably  sought  and  cheerfull}^  given. 

"  His  interest  in  the  work  and  appreciation  of  its  usefulness  grew 
with  his  j^ears,  and  it  was  not  until  after  a  personal  inspection  of  the  site 
selected  for  the  new  Institution  at  Grlen  Mills  that  the  contract  for  the 
purchase  was  entered  into.  His  approval  of  the  system  to  be  employed 
there  was  unqualified. 

'•  In  recording  his  generous  and  philanthropic  spirit  and  the  deep 
sympathy  evinced  b}^  him  with  the  unfortunate  cliildren  committed  to 
our  care,  we  are  but  uniting  in  the  universal  testimou}-  to  those  quali- 
ties which  he  exhibited  throughout  a  long  and  distinguished  professional 
career,  devoted  to  good  deeds  and  generous  acts." 

Mr.  Collins,  who  died  November  27,  1892,  the  venerable 
President  of  the  Board  of  Managers  of  the  House  of  Refuge, 
had  been  in  the  board  twenty  years ;  this  made  him  quite  a 
youth  compared  with  Dr.  Agnew's  service  of  thirty-three  years. 

Dr.  Agnew  was  a  member  of  the  Board  of  Directors  of 
the  Union  Trust  Company,  one  of  the  largest  financial  concerns 
of  Philadelphia.  This  company  was  a  conception  of  Colonel 
AYilliam  C.  Patterson,  of  Philadelphia,  its  charter  being  obtained 
on  the  16th  of  October,  1882.     Dr.  Agnew  was  made  a  mem- 


DR.    AGNEW'S    LATER    LIFE.  275 

ber  of  the  Board  at  the  first  meeting  of  the  Company,  and  con- 
tinued in  active  service  up  to  the  time  of  his  death.  He  was 
always  in  attendance  at  the  meetings  of  the  Board,  unless  pre- 
vented by  his  professional  duties,  and  his  advice  and  counsel 
were  always  sought  and  esteemed  to  be  of  great  value.  He 
did  not  waste  much  of  the  time  of  the  Board  in  long  discus- 
sions, but  he  did  not  hesitate  to  express  his  views  very  freely, 
when  the  occasion  required  it. 

At  a  meeting  of  the  Trustees  of  the  Philadelphia  Dental 
College,  held  November  29,  1881,  Dr.  Agnew  was  unanimously 
elected  a  member  of  the  Board.  On  April  19,  1872,  he  was 
made  a  member  of  the  American  Philosophical  Society  for  Pro- 
moting Useful  Knowledge.  He  was  also  a  member  of  the 
Franklin  Institute. 

On  February  19, 1872,  Dr.  Agnew  had  been  elected  one  of 
the  Consulting  Surgeons  to  the  Presbyterian  Hospital;  in  1890, 
he  was  made  Honorary  Surgeon  to  the  same  institution,  the  first 
time  such  a  position  had  been  created. 

At  the  meeting  of  the  Alumni  Society  of  the  Medical  De- 
partment of  the  University  of  Pennsylvania,  held  May  6,  1891, 
he  was  elected  Vice-President  of  the  society.  This  was  an 
unusual  honor,  as  the  officers  in  this  society,  as  a  rule,  are  not 
chosen  from  among  the  members  of  the  Faculty. 

Dr.  Charles  T.  Hunter,  who  had  been  Dr.  Agnew's  Demon- 
strator of  Surgery  for  many  years,  resigned  from  this  position  in 
1882;  he  was  advanced  to  the  position  of  Demonstrator  of 
Anatomy.  His  place  was  taken  by  Dr.  J.  W.  White,  who  assisted 
Dr.  Agnew  in  much  of  his  work  until  the  latter's  retirement 
permanently  from  professional  duties. 

Dr.  Agnew  delivered  the  introductory  address  to  the  course 
of  the  winter  1881-82,  and  the  valedictory  address  to  the 
graduating  class  in  1885. 

At  the  time  of  the  consideration  of  the  necessity  for  the 
establishment  of  a  compulsory  fourth  year,  in  1887,  Dr.  Agnew 
was  one  of  its  most  eager  advocates.     The  successful  establish- 


276  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

meiit  of  this  medical  advance  at  the  University  met  with  his 
warmest  approval. 

Dr.  Agnew  continued  his  lectures  at  the  University  until 
the  spring  of  1889.  During  the  winter  he  intimated  his  desire  to 
retire  from  active  service,  which  was  accomplished  by  his  election 
to  the  post  of  Emeritus  Professor  of  Surgery  and  Honorary 
Professor  of  Clinical  Surgery,  January  11, 1889.  By  the  former 
position  he  was  still  a  member  of  the  Faculty  with  all  its  privi- 
leges ;  by  the  latter  title — one  never  given  before  in  the  history 
of  the  University — lie  was  enabled  to  deliver  cliniques  to  the 
students  whenever  he  so  desired.  This  intention  he  carried 
out  from  time  to  time  until  within  a  short  period  before  his 
death. 

The  incidents  and  anecdotes  which  throw  side-lights  on  a 
man's  character  and  career  are  often  fortunate  in  revealing  the 
colors  and  details  of  a  human  life  which  would  otherwise  be 
lost  forever.  There  are  many  such  anecdotes  that  remain  of 
Dr.  Agnew's  career  which  tell,  far  more  forcibly  than  mere  de^ 
scription,  of  many  of  his  characteristics  ;  some  of  them  demand 
a  place  in  the  story  of  his  life,  for  their  value  in  thus  disclosing 
glimpses  of  himself  or  of  the  environments  of  his  life-work. 

His  regular  attendance  at  church  was  so  marked,  especially 
in  such  a  busy  physician,  that  the  following  little  incident,  which 
shows  his  arrangement  of  his  work  in  order  that  he  could  get 
to  church,  will  not  only  serve  as  a  lesson  for  practising  phy- 
sicians, but  also  emphasize  the  sacrifices  to  which  he  put  him- 
self, in  order  to  be  present  at  divine  worship : — 

In  the  early  seventies  he  asked  a  young  surgeon  of  the  city 
to  accompany  him  to  Gloucester,  New  Jersey,  to  see  an  inter- 
esting case  of  abdominal  tumor  in  a  woman.  It  was  necessary 
to  see  the  case  the  next  day,  which  happened  to  be  Sunday. 
The  young  surgeon  suggested  10  o'clock  as  a  good  hour  for 
starting ;  his  surprise  can  be  imagined  when  Dr.  Agnew  told 
him  he  would  stop  for  him  with  his  carriage  at  half-past  four  in 
■the  morning.    Dr.  Agnew  arrived  on  time,  and  they  reached  the 


DR.    AGNEW'S    LATEK    LIFE.  277 

ferry  by  5  o'clock,  took  the  first  boat  over,  and  Dr.  Agnew  was 
back  in  his  office  by  9  o'clock. 

Dr.  Agnew 's  quickness  of  retort  and  his  ability  to  see  the 
humorous  side  of  things  are  shown  in  the  following  incident: 
A  gentleman  in  the  country  was  unfortunate  enough  to  swallow 
a  set  of  false  teeth  while  eating  oysters  ;  they  stuck  in  his  throat, 
from  which  position  they  could  not  be  dislodged  by  the  efforts 
of  the  country  physicians  who  Avere  called  to  attend  him.  In 
consequence,  the  gentleman  came  in  great  distress  to  town  to  see 
Dr.  Agnew.  After  a  little  manipulation  the  doctor  removed  the 
teeth  from  the  throat  of  the  unfortunate  gentleman,  and  left  hira 
in  a  condition  practically  as  good  as  before  the  accident. 

The  news  of  this  incident  spread  through  the  city,  and 
consequently  a  reporter  called  on  Dr.  Agnew  about  midnight 
of  the  day  of  the  extraction.  As  was  Mrs.  Agnew's  custom,  in 
order  to  save  her  husband  as  much  exertion  and  exposure  as 
possible,  she  answered  the  call  to  the  night-bell.  She  told  her 
husband  that  there  was  a  person  down  stairs  who  wanted  to 
know  about  the  man  who  had  swallowed  his  teeth,  and  had 
been  operated  upon  that  day.  Dr.  Agnew  laughed  and  said : 
"  Tell  him  that  if  he  doesn't  oo  awav  from  mv  door  there  will 
be  another  man  in  Philadelphia  to-night  with  his  teeth  down  Ids 
throat." 

In  the  Medical  Neivs  of  July  28,  1883,  under  the  head  of 
"  Correspondence,"  are  a  couple  of  letters  on  a  publication,  en- 
titled "  An  Epitome  of  Medicine,  Surgery,  and  Obstetrics,  by 
Alfred  Stille,  D.  Hayes  Agnew,  and  R.  A.  F.  Penrose.  Published 
by  Samuel  M.  Miller,  M.D."     The  following  explains  itself: — 

To  the  Editor  of  the  Medical  News. 

Sir:  I  am  receiving  letters  from  A'arious  sections  of  tlie  country 
asking  for  information  in  regard  to  my  connection  with  a  little  A'olume 
published  b}- a  Dr.  Samuel  Miller,  and  entitled  "An  Epitome  of  Medi- 
cine, Surgery,  and  Obstetrics,  b}'^  Drs.  Alfred  Stille,  D.  Hayes  Agnew, 
and  R.  A.  F.  Penrose.'''  I  have  no  desire  to  increase  my  correspondence, 
already-  too  onerous,  and,  therefore,  deem  it  best  to  avail  m^-self  of  the 


278  LIFE    OF   D.    HAYES    AGNETT.    ?I.D.,    LL.D. 

columns  of  your  widely-circulated  journal  to  inform  my  profession:^! 
brethren  that  I  disown  any  relation  whatever  with  this  miserable  piece 
of  literary  larcen_v,  published  entireh'  without  my  knowledge,  and  only 
remarkable  for  inaccurac\',  stupidit}',  and  audacity  on  the  part  of  its 
author.  Yours,  trul}', 

D.  Hates  Agxetv. 

July  21,  1883. 

An  injunction  was  granted  subsequently  against  Dr.  Miller, 
restraining  him  from  publishing  and  selling  this  medical  work. 
On  behalf  of  the  defendant,  it  was  argued  by  his  attorney,  E. 
Spencer  Miller,  that  an  oral  delivery  of  matter  to  persons,  who 
attended  such  lectures  on  invitation  or  otlierwise,  became  com- 
mon propertv  to  those  who  were  present  and  remembered  the  sub- 
ject discussed.  He  said  that  the  students  had  never  been  notified 
that  the  lecturers  reserved  the  right  of  property  in  tlicir  lectures, 
but,  on  the  contrary,  directed  their  students  to  take  copious  notes 
of  the  lectures.  Judges  Hare,  Mitchell,  and  Fell  refused  to  dis- 
solve the  injunction,  saying  there  was  not  sufficient  evidence 
shown  to  induce  the  court  to  dissolve  it.  Still  later,  in  the  case 
of  appeal  of  Dr,  Samuel  M,  Miller  from  the  decree  of  Court  of 
Common  Pleas,  No,  2,  the  Supreme  Court  confirmed  the  decree 
of  the  lower  court;  so  that  the  book  was  permanently  sup- 
pressed. 

The  following  incident  occurred  many  times  in  Dr,  Agnew's 
career  when  he  was  called  into  consultation.  He  would  meet 
the  attending  physician  at  the  house  of  the  patient,  examine  the 
case,  and  retire  to  an  adjacent  room  in  which  to  talk  over  the 
case.  As  Dr,  Agnew  was  discussing  the  problems  presented, 
he  would  be  at  the  same  time  glancing  around  the  room.  On 
every  side  he  could  see  evidences  of  a  long,  unsuccessful 
struggle  against  poverty.  The  threadbare  carpet ;  the  dingy 
furniture ;  the  pinched,  wan  face  of  the  wife  or  mother, — 
all  told  their  story  of  a  bitter  struggle,  AYhen  the  time  came 
for  him  to  go,  as  was  customary  in  these  cases,  the  attending 
phvsician  would  ask  Dr.  Agnew  his  charge.  Dr.  Agnew  would 
mention  the  amount  of  his  bill,  the  physician  would  confer  with 


DR.    AGNEW'S    LATER    LIFE.  279 

the  mother  of  the  family,  and  Dr.  Agnew  would  be  paid  at 
once.  On  the  way  to  the  door,  Dr.  Agnew  would  find  some 
pretext  to  see  the  woman  unobserved  and  slip  back  into  her 
liand  the  money  which  he  had  just  received.  In  a  second  he 
was  gone  and  no  one  was  tlie  wiser  of  the  act,  not  even  his 
family  or  the  attending  physician. 

It  has  been  wisely  said  that  a  fool  cannot  lose  his  temper, 
and  a  wise  man  does  not.  Dr.  Agnew's  control  of  temper  was 
not  due  to  any  inability  to  see  harm  done  him,  or  provocation 
aroused.  He  could,  on  occasion,  be  most  stern  and  decisive 
in  his  words  and  actions.  They  seemed  all  the  sharper  and 
sterner  because  they  were  so  far  apart.  He  had  a  considerable 
amount  of  the  old  Scottish  blood  in  him.  An  incident  will  illus- 
trate this :  In  his  earlier  years  Dr.  Agnew  attended  a  woman 
suffering  from  an  incurable  affection, — chronic  tubercular  peri- 
tonitis. Eventually,  despite  all  that  was  done  for  her,  she  died. 
In  the  course  of  time  Dr.  Agnew  presented  his  bill  to  her  hus- 
band. He  knew  that  the  man  had  been  put  to  considerable 
expense  and  w^as  not  in  the  best  of  positions  financially.  His 
bill,  even  at  the  moderate  charge  which  he  Avas  accustomed  to 
make,  came  to  $180,  but  he  divided  it  by  ten  and  sent  a  bill 
for  $18.  A  year  rolled  by,  and  as  the  bill  was  still  unpaid  Dr. 
Agnew  sent  his  collector,  who  was  subjected  to  a  considerable 
abuse.  Somewhat  later  this  man  sent  the  bill,  with  a  check,  to 
Dr.  Agnew,  with  the  following  letter : — 

Dr.  Agnew. 

Dear  Sir  :  I  enclose  your  bill  witU  check  therefor.  Kindly  receipt 
it  and  return  to  me.  I  will  saj'-  that  I  never  paid  a  bill  under  greater 
protest.  You  promised  to  cure  my  wife  and  you  failed  to  do  it.  I  feel 
that  you  are  an  inefficient  physician  and  incapable  of  giving  proper 
medical  attention  to  your  patients.  Yours,  etc., 


Dr.  Agnew  sat  down,  receipted  the  bill  and  folded  up  the 
check,  and  put  them  together  in  an  envelope,  with  the  following 
note : — 


280  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

Dear  Sir  :  I  enclose  you  the  receipted  bill,  also  the  check  which 
you  sent.  Permit  me  to  sa}^  that  I  never  promised  to  cure  your  wife. 
That  is  a  power  which  belongs  only  to  God,  and  if  He  does  not  bless  our 
efforts  our  medicines  are  of  no  avail.  I  will  only  ask  one  favor  of  you. 
It  is  that  you  will  never  darken  my  office-door  again. 

Yours  sincerel}", 

D.  Hayes  Agnew. 

Such  discourtesy  was  most  unusual  in  Dr.  Agnew's  expe- 
rience. The  receipt  of  such  letters  as  the  following  was,  on  the 
other  hand,  a  common  experience : — 

My  Dear  Doctor:  Twenty -three  years  ago,  on  the  14th  of  March, 

I  went  out  to  0 in  the  morning  full  of  health  and  vigor,  and 

returned  in  the  afternoon  a  sad  cripple,  my  right  anIde-l)ones  broken 
in  pieces,  having  received  a  compound  comminuted  fracture — the  most 
teri-ible  accident  of  my  life.  Then  it  was  tliat,  by  your  skillful  and 
careful  treatment  and  watchful  attention,  assisted  by  Dr.  Smith,  that 
you  placed  me  upon  my  two  feet  again,  and,  instead  of  ever  thereafter 
limping  along,  I  have  traveled  life's  journey  for  twentj^-three  years 
longer,  wuncl  in  both  limbs.  And  as  to-day  is  the  anniversary  of  the 
accident,  I  wished  to  write  you  a  few  lines  and  tell  3'ou  I  bear  in  my 
heart  the  grateful  remembrance  of  all  your  kindness  to  me.  The  poet 
saj^s  :  "A  thing  of  beauty  is  a  joy  forever."  To  me,  a  ki72d  act  is  a 
most  precious  memory,  and  throws  a  brightness  over  all  my  after  life. 
And  can  1  forget  your  friendship,  with  all  the  kindness  I  have  received 
from  you?  JVeuer.  Years  may  and  do  bring  man}-  changes,  but  the 
heart  that  is  true  remains  the  same. 

So,  believe  me  as  ever,  affectionateh'  j^ours. 


Dr.  Agnew's  study  of  human  nature  was  often  most 
marked,  so  that  frequently  he  would  let  drop  a  remark  which 
would  linger  for  years  in  the  minds  of  his  auditors.  For  ex- 
ample :  a  gentleman,  in  explaining  to  him  the  condition  of  a 
patient,  said,  "  Doctor,  my  father  is  in  the  habit  of  taking 
a  couple  of  ounces  of  raw  whisky  before  dinner.  Do  you 
think  he  ought  to  give  it  np'?  Do  you  think  it  has  a  bad  effect 
upon  his  diseased'  Dr.  Agnew  replied:  "No;  a  man  of 
seventy  should  never  break  up  even  a  bad  habit." 


DR.    AGNEW'S    LATER    LIFE.  281 

A  gentleman  calling  on  the  elder  Gross  one  morning  noticed 
lying  on  his  desk  a  copy  of  "  Agnew's  Surgery,"  whicli  was 
then  just  published.  lie  asked  Dr.  Gross  what  ho  thought  of 
the  work.  In  the  impressive  style  for  which  Dr.  Gross  was 
noted,  he  said,  "  I  want  you  to  listen  to  what  I  am  going  to  say. 
I  sat  up  nearly  the  whole  of  night  before  last  reading  this  work, 
and  I  will  venture  to  assert  that  '  Agnew's  Surgery '  will  be  read 
and  consulted  by  the  medical  world  long  after  the  dust  has  settled 
forever  on  the  covers  of  similar  works."  The  visitor  asked, 
"  How  do  you  think  it  compares  with  your  own  work  '?  "  Dr. 
Gross  modestly  replied,  "  Why,  sir,  mine  is,  in  comparison,  a 
pigmy." 

The  following  interesting  letter,  written  to  Dr.  Agnew  by 
Dr.  Gross  in  regard  to  his  "  Surgery,"  shows  the  friendly  rela- 
tions existing  between  these  two  great  surgeons: — 

Philadelphia. 

My  Dear  Doctor  Agnew  :  I  thanked  you  in  jidvance  Inst  week 
for  your  kindness  in  sending  the  second  volume  of  3-our  "  Suroery."  Now 
that  an  opportunity  has  been  afforded  me  of  scanning  its  anii)le  pages,  let 
ine  thank  3"0U  again, — not  in  a  cokl  and  formal  manner  according  to  the 
workl's  fashion, — but  with  all  my  heart  and  soul.  Yon  have  produced  a 
great  and  noble  work, — one  creditable  alike  to  yourself,  j'our  profession, 
and  j^our  country. 

I  hope  and  pray  that  the  great  and  good  God — tlie  Father  of  ns 
all — ma}'-  give  you  health  and  strength  and  a  long  life  to  enjo}'  the  well- 
merited  fruits  of  your  labors.  Ever  faithfully  your  friend, 

S.  D.  Gross. 

Dr.  Agnew  did  not  keep  many  of  his  letters  or  other  data 
in  reference  to  his  work.  He  was  in  the  habit  of  destroying 
everything  as  soon  as  he  had  digested  its  contents  ;  and  although 
he  left  considerable  material,  it  was  not  one-hundredth  of  the 
amount  which  he  destroyed.  This  is  unfortunate  for  posterity, 
for  it  limits  considerably  tlie  outlines  of  his  life. 

A  Southerner  who  had  come  to  Dr.  Agnew  for  advice,  after 
leaving  his  office,  went  into  a  neighboring  drug-store  to  have  a 
prescription  filled,  asking  if  "  this  Agnew  over  the  way  was  the 


282  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

celebrated  Agnew."  Being  assured  that  it  was,  he  seemed  to 
hesitate,  and  then  said,  "  I  came  from  far  south  and  brought  a 
thousand  dollars  in  my  pocket  to  have  Agnew  give  an  opinion 
upon  a  malady  of  mine,  but  I  got  that  opinion  and  he  only 
charged  me  three  dollars,  and  I  don't  understand  it."  The 
•druggist  asked  if  he  w^as  slighted  in  any  way;  he  replied, 
"  Slighted  !  No  ;  on  the  contrary,  he  could  not  have  treated  me 
better ;  but  w4iy  he  did  not  charge  me  more  I  don't  know. 
He  merely  said  that  that  was  his  regular  charge  for  office  advice." 
This  disregard  of  Dr.  Agnew  for  possible  advantages  that  he 
might  take  of  tliose  who  came  to  him  and  his  exceeding  fairness 
toward  all  people  were  strongly  marked  through  his  whole  career. 

Dr.  Agnew  said  one  morning  to  a  friend,  "  I  saw  in  my 
office  this  morning  forty  patients.  How  much  money  do  you 
suppose  I  charged  and  received  for  my  morning's  work"?  "  The 
friend  being  unable  to  estimate,  Dr.  Agnew  said,  "  Twenty  dollars." 
In  other  words,  he  charged  only  one  out  of  four  or  six  patients. 
If  he  had  only  collected  what  even  his  moderate  charges  were, 
his  estate  would  have  been  at  least  three  times  larger  than  it 
was  at  his  death.  This  had  an  unexpected  effect  on  the  other 
physicians  in  the  town.  If  Agnew  charged  so  little  it  was  diffi- 
cult for  other  less  well  known  practitioners  to  charge  more. 
Undoubtedly,  Dr.  Agnew's  scale  of  fees  had  a  bearish  tendency 
in  the  great  medical  market.  This  circumstance  did  not  always, 
however,  deter  other  physicians  from  charging  their  usual 
prices,  even  when  called  into  consultation  at  the  same  time  that 
Dr.  Agnew  would  also  be  called.  For  example,  for  seeing  a 
patient  outside  the  city,  Dr.  Agnew  presented  a  bill  for  $50, 
while  another  professional  gentleman,  who  accompanied  him 
also  to  see  the  case,  younger  and  less  well  known,  sent  a  bill 
for  §250. 

There  were  a  number  of  incidents  which  occurred  in  Dr. 
Agnew's  work  at  this  period  which  are  of  sufficient  importance 
to  demand  attention.  One  of  these  was  the  occurrence  of  a 
deatli ;  the  only  one  which  happened  to  Dr.  Agnew  in  the  whole 


DR.    AGNKW'S    LATP:K    LIFE.  283 

course  of  liis  professional  career,  in  wliich  the  patient  died  while 
under  tlie  influence  of  ether.  As  the  case  is  of  great  value  as  a 
lesson  in  etherization,  its  outlines  are  briefly  presented.  Altliough 
the  deatli  was  proved  to  be  unavoidable,  it  is  most  fortunate 
for  the  medical  profession,  not  only  from  the  rareness  of  the 
incident,  that  it  occurred  at  all,  but  that  it  fell  to  the  lot  of 
Dr.  Agnew,  and  not  to  some  less  well  known  operator. 

After  forty  years  of  surgical  work,  often  of  the  gravest 
character,  and  sometimes  requiring  prolonged  anesthesia,  with- 
out a  single  accident,  Dr.  Agnew  had  come  to  believe  that  the 
exhibition  of  ether,  unless  recklessly  administered,  was  entirely 
free  from  danger.  He  was  aware  that  several  deaths  had  been 
reported  from  time  to  time  from  its  use,  even  in  the  hands  of 
the  most  careful  operators,  but  he  could  never  divest  his  mind 
of  the  idea  that  in  these  cases  there  was  some  undetected  ele- 
ment involved  more  influential  in  the  issue. 

Dr.  Agnew  was  engaged  in  preparing  to  operate  on  a 
gentleman,  45  years  of  age,  for  the  removal  of  two  ulcerating 
hemorrhoids.  The  patient  was  in  good  health,  the  heart  and 
kidneys  not  being  diseased.  One  year  before  Dr.  Agnew  had 
operated  for  fissure  of  the  sphincter  ani  on  this  same  patient,  at 
which  time  he  had  done  well  under  the  ether.  At  the  time  of 
the  second  operation,  nothing  occurred  during  the  early  stage 
of  the  inhalation  other  than  what  is  witnessed  every  day  when 
ether  is  exhibited.  In  the  course  of  fifteen  minutes,  the  patient 
was  placed  across  the  bed,  one  of  the  tumors  was  drawn  down, 
transfixed,  and  ligated  with  a  double  ligature.  When  about  to 
seize  the  second,  the  breathing,  which  had  been  strong  and  free, 
suddenly  ceased.  The  operation  was  immediately  suspended, 
and  the  usual  methods  for  resuscitation  instituted.  Notwith- 
standing these  measures  were  persisted  in  for  at  least  three 
quarters  of  an  hour,  during  twenty-five  minutes  of  which  time 
the  pulsations  of  the  heart  could  be  recognized,  not  a  single 
effort  of  natural  respiration  occurred.  The  post-mortem,  made 
by  Dr.   Formad,  the  coroner's  physician,  revealed  complete  col- 


284  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

lapse  of  the  lungs ;  marked  traces  of  an  old  meningitis,  attributed 
to  a  former  sun-stroke ;  and  what  satisfactorily  explained  the 
sudden  termination  of  life,  the  rupture  of  a  calcified  vessel  in  the 
floor  of  the  fourth  ventricle,  the  recognized  pliysiological  centre 
of  respiration.  All  the  vessels  comprising  the  circle  of  Willis 
were  in  a  similar  state  of  atheromatous  degeneration. 

It  was  evident,  therefore,  that  the  increased  vascular  ten- 
sion of  these  cerebral  vessels,  caused  by  the  ether,  determined 
the  lesion, — a  result  which  might  have  followed  any  unusual 
mental  or  physical  excitement.  Under  the  circumstances  this 
sad  disaster  could  not  have  been  avoided  by  any  human  fore- 
sight. The  ether  Avas  pure,  not  more  than  five  ounces  had  been 
inhaled,  and  there  had  been  a  sufficient  admixture  of  atmos- 
pheric air;  During  life  it  was  impossible  to  ascertain  the  state 
of  the  blood-vessels  of  the  brain  as  disclosed  at  the  autopsy, — a 
very  improbable  condition  in  a  man  of  45  years. 

Dr.  Agnew  had,  curiously,  about  the  same  time,  a  case 
in  which  he  was  called  to  see  a  woman  more  than  70  years  of 
age,  who  was  suffering-  from  strangulated  hernia.  They  were 
just  preparing  to  give  her  the  ether,  when  the  patient  gave  a 
sudden  convulsive  movement  and  expired  in  a  moment.  Had 
the  etherization  been  commenced  or  the  operation  begun  be- 
fore the  death  of  the  woman,  the  fatal  result  would  have  been 
attributed  either  to  the  anesthetic  or  the  knife. 

The  following  tribute  of  respect  to  Dr.  Agnew's  memory 
was  written  by  a  former  patient.  It  expresses  two  such  good 
points  that  it  is  quoted  : — 

"His  manner  in  the  sick-room  is  worthy  of  study ;  he 
would  first  shake  hands  with  his  Y)atient  in  the  most  kindly  and 
courtly  manner  and  sit  down  as  quietly  and  composedly  as  if  he 
had  not  another  patient  in  the  world,  and  evidently  intended  to 
remain  until  everything  had  been  discussed  and  considered. 
He  would  listen  patiently  to  the  explanations  of  his  patient^ 
give  his  decisions  and  advice  quickly  and  incisively,  and  then 
refer   to   some   topic  of  pleasant  conversation  ■  which  he  knew 


DR.    AGNEW'S    LATER    LIFE.  2<S5 

would  be  of  interest  to  the  patient.  When  he  went,  he  had  made 
all  feel  that  notliin'>-  had  been  left  unsaid  or  undone.  Fre(|iiently, 
after  he  was  gone,  my  wife  would  say,  'Oh,  dear,  the  doctor  never 
sees  me  when  I  am  bad ' ;  the  fact  being  that  slie  forgot  her 
suffering,  and,  after  the  questions  as  to  her  treatment  had  been 
decided,  she  had  been  endeavoring  to  entertain  him  by  showing 
him  whatever  new  shell,  butterfly,  or  beetle  slie  had  received. 

"  Of  Mrs.  Agnew  but  little  has  been  written.  The  world 
should  know  what  a  loving  and  kind-hearted  woman  she  is,  and 
what  a  help-meet  she  was  to  her  husband.  As  a  matter  of  fact, 
he  owes  a  large  part  of  his  success  in  life  to  her, — not,  of  course, 
his  professional  success,  but  it  was  by  her  great  and  unceasing 
watchfulness  over  him  in  sickness  and  in  health,  and  relieving 
him  from  all  business  matters,  from  all  petty  annoyances,  that 
enabled  him  to  devote  his  undivided  attentions  and  energies  to 
his  professional  work.  Never  was  there,  a  couple  better  suited 
to  each  other." 

Dr.  Agnew's  influence  as  an  expert  in  medico-legal  cases 
was  a  natural  outgrowth  of  his  work  in  other  directions.  His 
appearance  on  the  witness-stand  was  always  a  source  of  impreg- 
nable strength  for  the  side  on  which  he  testified,  for  his  vast 
erudition  and  experie.nce,  combined  with  his  well-known  hon- 
esty and  conscientiousness,  made  it  possible  for  him  to  rebut 
any  testimony  contrary  to  his  own  which  might  be  offered  by 
an  opposing  attorney. 

Dr.  Agnew's  testimony  as  an  expert  led  him  frequently  to 
testify  in  cases  in  which  he  felt  that  he  should  place  on  record 
his  experience,  especially  when  such  expert  testimony  was  given 
that  he  believed  was  doing  an  injustice  in  any  way  to  an  inno- 
cent person.  For  example,  he  went  to  Xew  England  in  the 
spring  of  1886  to  testify  in  a  case  of  a  poor  colored  man  who  had 
been  charged  with  murder,  in  which  the  case  turned  upon  the 
point,  whether  it  is  possible  for  an  individual  with  suicidal  intent 
to  inflict  a  shot  wound  in  the  brain  and  another  in  the  heart.^ 

1  See  page  197. 


286  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

Dr.  Agnew  was  so  honest  that  he  frequently  failed  to  see 
the  intrigues  of  others ;  in  consequence,  he  allowed  himself 
occasionally  to  be  the  source  of  advertisement  to  those  who 
were  seeking  to  advance  their  own  interests.  This  tendency  on 
his  part  increased  as  he  grew  older ;  in  his  later  years  he  per- 
mitted many  things  to  pass  wliich,  occurring  earlier  in  his  life, 
he  would  have  quickly  stopped.  This  tendency  was  recognized 
by  his  friends,  and  it  did  not  create  the  surprise  which  might 
have  otherwise  naturally  arisen. 

All  through  this  decade  Dr.  Agnew  was  endeavoring  to 
decrease  his  work  ;  he  resigned,  in  188J:,  from  the  Pennsylvania 
Hospital,  and  in  his  practice  he  limited  his  work  as  far  as 
possible.  Still,  he  did  far  more  work  than  he  had  outlined 
for  himself 

When  Dr.  and  Mrs.  Agnew  came  to  Philadelphia,  they 
joined  the  church  of  the  Rev.  T.  H.  Beveridge,  at  Twenty- 
second  and  Race  Streets.  This  was  an  Associate  Presbyterian 
Church,  of  the  same  division  of  Presbyterianism  of  which  Dr. 
Agnew's  parents  had  long  been  members.  Subsequently,  they 
transferred  their  membership  to  the  Tenth  Presbyterian  Church, 
at  Twelfth  and  Walnut  Streets,  at  that  time  under  the  charge 
of  the  Rev.  Henry  Boardman,  D.D.  They  remained  regular 
attendants  at  this  church  until  1865,  when  they  joined  the 
Second  Presbyterian  Church,  where,  until  his  death.  Dr.  Agnew 
was  a  regular  attendant. 

In  1863  Dr.  Agnew  began  his  romantic  attachment  with 
the  late  Rev.  Elias  R.  Beadle,  D.D.,  when  he  had  the  pleasure, 
first,  of  hearing  this  gifted  minister  preach.  It  was  in  the  Tenth 
Presbyterian  Church  where  this  occurred.  Dr.  Beadle  took 
charge,  temporarily,  of  the  congregation  of  Dr.  Boardman  and 
of  Dr.  Crowell  during  the  absence  of  these  pastors  in  the 
summer-time.  He  entered  the  church  and  took  a  back-seat  on 
a  side-aisle,  until  the  hour  for  service  arrived ;  then  he  arose, 
walked  with  a  rapid,  nervous  step  down  the  aisle,  and  ascended 
the  pulpit.     There  was  something  about  the   man  which  im- 


DR.    AGNEW'S    LATER    LIFE.  287 

mediately  awakened  Dr.  Agnew's  interest.  The  sliarply  cut 
features,  the  deep  hues  which  furrowed  a  thouglitful  face,  and 
the  quick,  nervous  movements,  all  revealed  the  fire  which  flamed 
beneath  the  surface.  Tlie  voice  and  manner,  the  form  and  force 
of  expression,  the  elegance  of  diction,  all  conspired  to  make 
one  magnificent  harmony.  Dr.  Agnew,  as  well  as  others,  at 
once  recognized  that  in  the  delicate,  wiry  body  of  the  speaker 
God  had  enshrined  a  soul  full  of  beatitudes. 

Notwithstanding  the  heat  of  midsummer  and  the  depopu- 
lated state  of  the  city,  Dr.  Beadle  soon  attracted  large  congre- 
gations of  highly  educated  and  appreciative  hearers.  The 
following  year  Dr.  Beadle  spent  in  Rochester,  N.  Y.,  supplying  a 
vacant  pulpit  in  that  city;  but  the  rigor  of  the  climate  compelled 
him  to  seek  a  more  congenial  spot,  and,  in  1865,  he  was  called  to 
the  Second  Presbyterian  Church  of  Philadelphia,  then  situated 
on  Seventh  Street,  between  Market  and  Arch. 

In  consequence  of  the  drift  of  population  westward  and 
the  encroachment  of  trade,  a  process  of  disintegration  had  been 
going  on  for  years  in  this  historic  old  church  which  rendered  a 
change  imperative.  When  a  few  remaining  worshipers  turned 
their  backs  on  the  church  hallowed  by  so  many  sacred  memories, 
it  was  with  sad  hearts ;  after  leading  a  nomadic  life  for  some 
time,  this  body  at  length  selected  the  site  at  Twenty-first  and 
Walnut  Streets,  and  there  erected,  in  1876,  the  present  imposing 
edifice,  where  the  last,  and  not  the  least,  prosperous  years  of  Dr. 
Beadle's  singularly  successful  ministry  were  spent. 

Dr.  Beadle,  after  his  license  to  preach  in  1835,  had  been, 
for  several  years,  a  missionary  to  India  and  Syria;  but  his  health 
did  not  permit  of  his  continuance  in  this  work,  and  he  had 
returned  to  America  in  1843.  From  this  time  he  worked  in  home 
fields.  His  intimacy  with  Dr.  Agnew  was  marked  from  the  outset 
of  their  acquaintance.  It  was  partly  through  Dr.  Agnew  that  he 
was  called  to  Philadelphia ;  scarcely  a  day  passed  during  the 
following  years  that  they  did  not  see  each  other.  Dr.  Beadle 
was  fond  of  calling  on  his  friend  at  supper-time ;  he  would  run 


288  LIFE    OF    D.    HATES    AGNET7,    M.D.,    LL.D. 

ill  unaniioimced  at  this  time,  and  tliese  two  workers  would 
spend  an  liour  or  so  in  congenial  talk. 

On  Sabbath  morning,  January  5,  1879,  Dr.  Beadle  preached 
with  his  usual  earnestness  and  power,  and  at  the  close  of  the 
service  touchingiy  announced  the  consummation  of  a  long- 
cherished  hope, — that  he  had  lived  to  see  cancelled  the  onerous 
debt  which  had  hung  over  the  beautiful  temple  in  which  he  and 
his  people  had  worshiped,  at  the  same  time  saying,  "  My  work 
is  now  done."  The  words  were  prophetic;  it  was  his  last 
Gospel  message  ;  his  work  was  done. 

One  hour  later  Dr.  Agnew  was  hastily  summoned  to  his 
aid.  On  entering  the  room  in  which  he  was  placed,  Dr.  Agnew 
found  the  poor  sufferer  seated  on  a  sofa,  but,  alas !  how  changed. 
He  had  been  seized  with  the  agony  of  cardiac  angina,  and  the 
face  that  an  hour  before  had  been  beaming  with  exultant  joy 
was  now  shrunken,  the  wrist  pulseless,  and,  with  the  desperate 
clutch  of  the  fingers,  was  heard  the  half-suppressed  moan  of 
one  in  mortal  trouble.  Shortly  after  midnight  the  gentle  spirit 
of  Beadle  was  released  from  its  mortal  environment  and  passed 
from  the  Church.  Militant  to  the  Church  Triumphant. 

In  1880  the  Bev.  John  S.  Macintosh,  D.D.,  of  Belfast, 
Ireland,  was  called  to  the  empty  pastorate.  He  had  charmed 
and  delighted  Philadelphia  by  his  brilliant  and  feeling  sermons 
the  year  before,  during  the  Council  of  the  Presbyterian  Alliance. 
Dr.  Macintosh  accepted  the  call,  and  was  installed  in  1881. 
Dr.  Macintosh's  own  words  in  the  estimate  of  Dr.  Agnew's 
career,  and  his  fiineral  sermon,  express  the  relations  that  existed 
between  Dr.  Agnew  and  himself 

These  suijii-estive  notes  and  reminiscences  are  furnished  by 
Dr.  Agnew's  pastor,  who,  despite  the  fact  that  he  preached  two 
sermons  on  Dr.  Agnew's  life  in  quick  succession,  still  had  left 
these  beautiful  thoughts  touching  his  dead  friend : — 

"It  was  my  happy  fortune  to  be  thrown  very  closely  with 
Dr.  Hayes  Agnew  from  the  very  first  moment  of  my  return  to 
Philadelphia,  and  it  is  a  matter  of  liighest  satisfaction  to  my- 


DR.    AGNEW'S    LATER    LIFE.  289 

self  that  the  succeeding  years  only  tightened  the  bonds  of  inti- 
macy, until  we  became  the  very  closest  and  most  confiding 
of  friends.  During  the  later  years  of  Dr.  Agnew's  life,  it  is,  I 
think,  the  simple  truth  for  me  to  say  that  no  man  was  honored 
with  his  closest  confidences  as  I  myself  was,  and  no  man  saw 
or  heard  so  much  of  liis  inner  life. 

"  But  a  great  deal  of  that  which  was  thus  in  the  freedom  of 
frankest  friendship  unveiled  to  my  eye  must,  through  the  sacred- 
ness  of  affection  and  a  solemn  sense  of  duty  to  the  d(^ad,  remain 
forever  sealed  up  in  my  own  memory  and  guarded  in  my  own 
heart.  To  rest  a  welcome  guest  at  a  man's  fireside ;  to  sit  at 
his  table;  to  share  his  home-life  ;  to  enter  into  his  sick-chamber; 
to  talk  with  him  when  laid  upon  his  bed ;  to  read  his  uncovered 
spirit-life  and  enjoy  his  trustful  confidences,  and  tlien  go  out 
and  talk  about  him  and  tell  what  was  never  expected  to  be 
told,  and  set  in  cold  print  what  was  only  opened  by  a  loving 
heart  to  a  loving  eye, — what  true  man,  with  tender  heart  and 
high  sense  of  honor,  can  ever  bring  himself  to  y^lay  such  a  part! 
Therefore,  it  is  not  for  me  to  say  much  of  this  inner  life,  and 
open  up  to  the  public  eye  many  of  these  holy  confidences. 

"  But  times  come  and  calls  are  heard  when  speech  about 
your  absent  friend  is  the  purest  loyalty  of  the  loving  heart,  and 
there  are  seasons  when  busy  men  and  women,  struggling  to  do 
the  right  and  to  grow  better,  have  a  just  claim  upon  those  that 
knew  the  purer  and  truer  souls  ;  knew  them  not  simplv  for  them- 
selves, but  for  the  help  of  their  fellows,  and  for  the  glory  of  that 
God  who,  by  his  grace  and  presence,  made  these  bright  spirits 
very  much  what  they  were.  There  are  a  few  choice  souls  wliom 
their  fellows  need  to  know,  and  it  brightens  the  world  to  see 
them  in  their  home-life  and  know  a  little  of  the  play  of  their 
great,  honest  hearts.  There  are  strong  and  sympatlietic  brotliers 
whose  inner  life  is  the  secret  of  their  outer  strength.  Tlie  man 
in  his  home  and  the  man  before  God  explain  the  man  among 
men  and  the  man  at  his  work. 

"  The  wish  to  know  the  hidden  man  is  right.     Ever  and 

19 


290  LIFE    OF    D.    HATES   AGNEW,    M.D.,    LL.D. 

anon  there  walks  among  the  crowd  one  whose  face  shmes, 
though  he  himself  wists  it  not,  and  his  wondering  fellows,  look- 
ing with  awe  and  admiration  on  liim,  want  to  know  whence 
comes  that  sweet  but  awful  light ;  and  when  they  learn  the 
secrets  of  the  brightness  it  betters  and  sweetens  their  own 
spirits. 

"  Since  Agnew  went  away  from  us  there  are  many  feeling 
poorer  by  his  very  loss,  and  they  are  asking  those  of  us  who 
knew  him  best,  whence  came  and  what  formed  that  singular 
wealth  of  personality  which  made  richer  those  who  touched  our 
departed  friend,  by  their  very  contact  with  him  1  Hard,  indeed, 
it  is  to  pack  such  a  man  and  the  secret  of  his  life  into  a  few 
sentences.  Yet  were  it  serious  wrong  to  him  if  speech  w-ere 
unduly  long  or  praise  grow  fulsome.  The  calm,  severe  dignity 
of  this  modest  and  self-hiding  man  demands  that  words  be  few 
and  well  ordered. 

"  What  manner  of  man  was  this,  as  he  lived  among  his 
more  intimate  friends  and  moved  in  the  sweet  circle  of  his  homel 
He  was  a  man  of  moral  symmetry.  He  was  a  man  of  purest 
kindliness ;  of  most  devout  piety ;  of  settled  faith  and  strong 
convictions  ;  of  broad  catholicity  and  spiritual  generosity. 

"  His  Morcd  Sijmmetry. — In  the  human  form  what  is  more 
winsome  than  symmetry  ;  fine  balance  of  parts  ;  harmony ;  true 
proportions  and  perfect  articulation "?  To  see  a  youth  of  sym- 
metric form  is  indeed  a  joy  forever,  but  there  is  a  symmetry  of 
soul,  there  is  a  moral  balance,  an  equipoise  which  is  finer  and 
sweeter  by  far  than  tlie  bodily  ;  a  symmetry  of  soul  where 
great  qualities  meet  and  are  harmonized.  Hayes  Agnew  carried 
with  him  this  great  and  singular  beauty  of  spirit. 

"  Looked  at  from  the  moral  point  of  view,  there  were  few 
things  lacking  in  his  spiritual  make-up,  and  there  was  nothing 
out  of  proportion.  He  was  marked  by  clearest  truth,  by  child- 
like simplicity,  by  sweet  modesty,  heroic  firmness,  steady  earnest- 
ness, winsome  gentleness,  unchanging  cheerfulness,  peculiar 
conscientiousness,  and  holiest  reverence.     Every  one  who  knew 


Dr.  Agnew  in  1887. 


DR.    AGNEW'S    LATER    LIFE.  291 

him  well  would  admit  that  each  one  of  these  high  qualities  of  mind 
and  heart  and  spirit  was  found  in  him,  and  that  they  all  made 
themselves  felt  by  those  who  came  in  contact  with  him,  and  that 
they  shone  forth  brightly  upon  those  who  lived  in  the  close  rela- 
tionships of  near  friendships  and  tlie  home.  And  yet  a  singular 
fact  was  that  you  scarcely  knew  which  of  these  was  the  master 
feature,  for  in  him  truth  and  gentleness,  modesty  and  firmness, 
simplicity  and  earnestness,  conscientiousness  and  forbearance, 
cheerfulness  and  reverence  went  together.  One  quality  was 
checked  by  another ;  one  feature  balanced  another,  and  tliey 
were  combined  into  a  sweet  unity  of  a  great,  strong,  good  man. 
In  the  number,  in  the  variety  of  his  moral  characteristics,  lay 
much  of  the  strength  of  his  character,  but  the  chief  power  of  it 
was  found  in  the  happy  balance  of  his  features  of  soul.  It  was 
the  strength  of  his  character  that  tells  largely  the  secret  of  his 
remarkable  hold  upon  the  community.  Confidence  in  the  man 
himself  was,  perhaps,  as  marked  as  confidence  in  the  surgeon  of 
unrivaled  skill. 

'•''His  Purest  Kindliness. — Agnew's  eye  was  remarkable. 
Those  who  knew  him  well  know  and  recall  that  fact.  There 
was  a  steady  penetration  in  it  that  seemed  to  go  right  down  to 
the  bottom  of  the  person  or  the  thing  he  looked  at.  But  there 
was  also  in  it  a  serene  pity  that  made  you  feel  you  had  found 
not  a  patron  in  him,  but  a  friend.  It  was  a  joy  to  him  to  do  an 
act  of  kindness,  and  that  was  almost  an  hourly  deed.  During 
the  later  years  of  his  life,  when  it  became  tolerably  well  known 
that  he  and  I  were  very  close,  intimate  friends,  I  was  constantly 
approached  by  those  who  were  in  need  of  help  of  various  kinds 
and  desired  an  introduction  to  Dr.  Agncw.  Wherever  and 
whenever  such  an  introduction  was  given,  the  applicant,  whether 
in  suffering  or  in  want,  was  sure  of  a  kindly  hearing,  and,  with 
scarce  an  exception,  received  help  and  attention.  There  were 
three  classes  whom  he  recognized  as  having  what  he  called 
'  first  claim  on  my  care.'  These  were :  doctors  in  suffering, 
sick  and  struggling  ministers,  and  those  of  God's  poor  who 


292  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

were  in  special  pain  or  burdened  with  incurable  troubles.  The 
most  of  his  own  profession  have  testified  in  public  to  his  open 
hand  and  open  heart  in  meeting  the  calls  of  his  suffering 
brethreii,  and  the  geneiosity  with  which  he  ofttimes  admin- 
istered to  the  wants  of  those  who,  through  physical  infirmity 
or  some  inexplicable  break-down  in  their  professional  life,  were 
no  longer  able  to  provide  for  themselves. 

"  It  may  be  permitted  me  to  say  that  if  he  was  the  doctors' 
doctor  he  was  also  the  pastors'  physician.  Since  his  death  there 
have  multiplied  to  me  singular  testimonies  of  the  pure  kindli- 
ness and  thoughtfulness  of  my  departed  friend  to  the  members 
of  my  own  profession.  Just  last  week  it  so  chanced  that  public 
duty  called  me  to  a  neighboring  town,  where,  in  a  goodly  com- 
pany of  Christian  ministers,  the  conversation  drifted  to  Dr.  D. 
Hayes  Agnew.  In  the  course  of  that  talk  this  fact  was  pressed 
home  upon  my  attention :  that  every  clergyman  there  present 
knew  several  instances  where  Dr.  Agnew  had,  for  a  longer  or 
shorter  time,  ministered  to  some  suffering  preacher  or  given 
advice  and  lent  his  skill  for  the  recovery  of  some  member  of  a 
ministerial  household. 

"  One  witness  gave  the  following  illustration  :  '  A  brother 
minister  of  mine  went  to  Philadelphia  to  consult  Dr.  Agnew 
about  a  severe  trouble  of  his  own.  He  saw  the  doctor,  who 
examined  him  carefully,  prescribed  for  him,  and  told  him  when 
to  return.  This  care  and  ministration  went  on  in  the  case  of 
the  suffering  pastor  for  well  nigh  two  years,  until,  through  the 
blessing  of  God  and  the  skillful  treatment  of  Dr.  Agnew,  the 
minister  was  restored  to  perfect  health  and  strength.  Some 
little  time  after  his  recovery  the  clergyman  wrote  to  Dr.  Agnew, 
asking  for  his  bill,  and  received  the  following  remarkable  and 
touching  answer : — 

"  '  Reverend  and  Dear  Sir:  That  I  have  been  permitted  to  min- 
istei'  to  3^ouv  relief  and,  throngh  the  blessing  of  God  on  m}'  efforts,  have 
been  enabled  to  be  of  help  to  j'ou,  is  a  source  of  greatest  gratification 
to  myself     You  owe  me  nothing.     To  your  Master  and  my  own  I  owe 


DR.    AGNEW'S    LATER    LIFE.  293 

all  things,  suul  to  serve  one  of  His  poor,  suffering  messengers  is  but  a 
little  service  rendered  to  Him  who  gave  Himself  for  me.     All  I  ask  is 
tliat  you  pray  for  me  ;  tliat  is  the  richest  return  thut  you  can  make. 
"  '  I  am  yours  in  Christian  friendsiiip, 

"  '  D.  Hayes  Agnew.' 

"  Another  minister  present  at  the  table  said :  '  Well,  I 
know  a  preacher  who  was  tended  by  Dr.  Agnew  for  nearly  a 
year,  and  when  he  was  quite  better  asked  the  doctor  what  he 
was  in  his  debt.  With  one  of  those  kindly  smiles  that  marked 
Agnew  and  a  gentle  tone  Dr.  Agnew  asked  him  :  "  How  much 
do  those  people  down  in  the  country  give  you  ]  "  The  preacher 
named  a  very  modest  salary.  "  Oh,  well,"  said  Dr.  Agnew, 
"  when  they  quadruple  your  salary  come  back  and  tell  me  and 
w^e'll  talk  about  the  fee."  ' 

'•  I  can  myself  testify  that  on  very  many  occasions  I  have 
spoken  to  him  about  some  poor  man  or  woman  whose  peculiar 
case  demanded  special  advice,  and  I  have  never  so  spoken  to 
him  that  he  has  not  either  gone  to  see  the  sufferer  or  had  the 
patient  come  and  see  him,  and  it  was  all  done  with  a  sweet 
courtesy  and  a  tender  sympathy  that  showed  that  Dr.  Agnew 
felt  himself  blest  and  honored  in  being  permitted  to  help  any 
of  the  deserving  poor. 

''His  Devout  Piety. — If  there  ever  were  a  simple-minded, 
humble,  devout  Christian  man,  it  was  D.  Hayes  Agnew.  He 
was  a  man  of  prayer.  For  himself  he  felt  and  owned  the  need 
of  daily  and  close  communion  with  God.  An  early  riser,  the 
first  part  of  the  day  was  consecrated  to  this  fellowship  of  the 
Spirit  with  his  Father  in  Fleaven ;  and  it  was  a  rare  thing,  indeed, 
when  he  allowed  the  most  sudden  and  urgent  call,  even  at  an 
unusually  early  hour,  to  take  him  from  his  home  without  first 
bending  at  the  family  altar,  and  leading  with  earnest  tone  and 
reverent  spirit  and  loving  heart  the  thoughts  of  his  family  up  to 
God,  and  seeking  for  them  the  Divine  blessing  and  for  himself 
the  Divine  guidance  in  his  work  and  the  help  of  the  Great 
Physician  in  the  discharge  of  his  own  professional  duties.     More 


294  LIFE    OF   D.    HAYES    AGNEW,    M.D.,    LL.D. 

than  a  score  of  times  have  we  talked  together  upon  the  power 
and  necessity  of  prayer  to  men  living  public,  noisy,  professional 
lives.  It  is  the  close  hold  of  a  man's  soul  upon  the  unseen 
God  that  makes  him  strong  for  duty  and  kindly  among  his 
fellows.    -That  was  a  realization  of  Dr.  Agnew's  experience. 

"  He  was  a  diligent  student  of  the  Bible.  His  habit  for 
years  had  been  regularly  and  systematically  to  read  through  the 
entire  Word  of  God.  This  work  was  not  done  as  a  mere  piece 
of  routine.  It  was  not  done  for  the  mere  sake  of  doing  it.  He 
read  thoughtfully;  compared  scripture  with  scripture;  searched 
the  scriptures,  and  had  the  Word  of  Christ  dwelling  in  him 
richly,  in  all  wisdom  and  spiritual  understanding.  If  you  made 
Dr.  Agnew  a  present  of  a  book,  there  was  no  gift  that  he 
welcomed  so  gladly  and  with  so  profuse  thanks  as  some  work 
casting  fresh  light  upon  the  Word  of  God.  Travels  in  the  Holy 
Land,  descriptions  of  Biblical  life  and  customs,  accounts  of 
explorations  making  more  intelligible  hints  and  references  con- 
tained in  the  Old  Testament,  were  all  eagerly  hailed  by  him 
and  carefully  studied.  He  was  one  of  those  who  meditated  on 
God's  word.  It  was  a  very  common  thing  for  him  to  have  for 
his  more  intimate  clerical  friends  a  number  of  very  difficult 
questions  in  connection  with  the  meaning  of  scripture,  and  as 
he  would  put  these  to  you  you  felt  immediately  that  you  were 
dealing  -with  a  man  who  had  thought  very  deeply  upon  the 
subject  presented  to  you  for  explanation.  One  of  the  last  topics 
on  which  he  and  I  conversed  together  was  the  nature  and 
meaning  of  the  demoniacal  possessions  referred  to  in  the  New 
Testament. 

""  He  was  a  lover  of  the  Sabbath.  He  did,  indeed,  count 
it  an  honor  and  a  delight,  and  resolutely  and  reverently  set  it 
apart  for  spiritual  rest  and  refreshment.  As  he  himself  said,  he 
had  an  abhorrance  of '  Sunday  physic'  He  regretted  exceedingly 
whenever  necessity  and  the  supreme  call  of  mercy  required  him 
to  give  up  to  professional  work  and  duty  any  part  of  the  sacred 
hours  of  the  Lord's  Day.     And  with  that  quiet  dignity  that  so 


DR.    AGNEW'S    LATER    LIFE.  295 

strongly  marked  him  when  lie  chose  to.  show  it,  he  resented 
anything  like  an  impertinent  interference  with  his  quiet  enjoy- 
ment of  his  time  of  rest  and  worship.  Tlie  inner  circle  that 
knew  him  best  knows  full  well  the  pained  look  that  came  across 
his  face  when  some  one  with  abundance  of  leisure  intruded  him- 
self upon  the  quiet,  thoughtful,  Christian  man,  enjoying  the 
calm  of  the  Sabbatic  afternoon,  to  obtain  advice  that  could  just 
as  easily  have  been  had  upon  the  morrow. 

"  He  was  a  constant  attendant  upon  church  ordinances, 
and  morning  and  evening  his  tall,  erect  form  was  seen  in  the 
House  of  God,  and  from  the  beginning  to  the  end  of  the 
service  his  reverent  attention  never  faltered,  and  his  manifest 
enjoyment  was  clearly  written  upon  his  countenance. 

"  His  Settled  Faith  cmd  Convictions. — He  was  a  man  of 
settled  faith  and  of  strong  convictions.  He  knew  what  he  be- 
lieved and  why  he  held  his  faith  so  fast.  He  had  searched  and 
tried  liimself  in  the  realized  presence  of  God.  He  had  carefully 
compared  scripture  with  scripture.  He  had  earnestly  and 
steadily  faced  and  fought  his  doubts  and  difficulties.  He  had 
groped  tlirough  many  an  hour  of  thick-set  darkness.  He  had 
plumbed  the  deep,  sullen  waters  of  perplexities  and  seeming 
contradictions.  He  had  pushed  his  way  through  stormy  seas 
of  controversies,  and  the  end  of  it  all  was :  *•  I  know  whom  I 
have  believed,  and  I  am  persuaded  that  He  is  able  to  keep  what 
I  have  committed  to  Him  against  the  day.' 

"  In  the  closing  years  of  his  life,  his  mind  was  at  perfect 
rest  in  tlie  clear,  serene  light  of  established  trust  and  convic- 
tions, yet  was  he  ever  ready  to  face  and  fairly  consider  every  new 
question  reverently  put  and  backed  up  with  arguments  of  seem- 
ing strength.  During  these  past  ten  years  not  a  single  subject 
of  debate  has  come  up  upon  the  confessional  field,  or  within  any 
of  the  great  ecclesiastical  lines,  on  which  he  and  I  have  not 
talked  frequently  and  fully.  He  had  thought  each  one  of  them 
out  for  himself,  and  arrived  at  clean-cut  and  definite  conclusions. 
He  rested  implicitly  in  the  Word  of  God.     He  was  satisfied  that 


296  LIFE    OF    D.    HATES    AGXETT,    M.D.,    LL.D. 

when  the  last  full  word  was  spoken  by  science,  it  avouIcI  be  in 
accord  with  the  Word  of  God,  or,  at  least,  in  no  antagonism  to 
it.  He  held  firmly  by  the  unity  of  truth,  full  truth,  simple 
truth. 

"  As  to  his  creed  and  church,  he  was  a  positive  Presbyterian. 
Privately  and  publicly,  with  great  gladness  of  heart,  and  yet 
w^ith  no  ofFensiveness,  he  avowed  himself  a  lover  of  the  old  blue 
banner.  He  honored  her  history ;  he  loved  her  simple  ways. 
He  delighted  in  the  direct  and  unimpeded  intercourse  which  she 
gave  the  soul  in  her  address  to  God  and  her  manner  of  com- 
munion with  Him  and  the  seeking  of  His  face.  In  the  later 
questions,  stirred  within  the  pale  of  bis  own  communion,  he 
took  a  very  lively  interest,  and  held  strong,  clear  opinions. 

"  His  Broad  CatlioJicity  of  Spirit. — He  was  settled  in  his 
own  convictions,  but  he  was  tolerant  of  the  opinions  of  others, 
and  catholic  in  the  true  sense  of  the  word.  He  loved  his  own 
church  best,  but  was  generous  in  thought  and  kindly  in  feeling 
toward  all.  He  had  many  friends  in  all  the  churches,  and  in  all 
the  communions  of  Christ  he  recognized  admirable  features. 
He  was  intelligently  acquainted  with  their  doctrines,  with  their 
historv,  and  their  forms  of  worship,  and  he  recognized  the  good 
that  was  in  each  of  them.  Standing  firmly  upon  his  own  Pres- 
bvterian  foundation,  he  said,  from  tlie  depth  of  his  heart :  '  I 
believe  in  the  communion  of  the  saints.'  He  preferred  the  char- 
acteristic worship  of  the  church  of  his  fathers,  but  felt  by  no 
means  a  stranger  in  any  of  the  sanctuaries  of  his  Christian 
brethren.  Wherever  the  message  of  liis  blaster  came  to  him, 
he  received  it  reverently  and  lovingly,  no  matter  what  mouth 
spake  it  or  in  what  peculiar  form  of  worship  it  found  its  place. 
Thus  I  recall  him,  the  man  who  gathered  unto  himself  and 
sweetly  combined  and  harmonized  so  many  moral  excellences ; 
the  man  of  gentle  speech  and  kindly  spirit ;  the  man  of  deep, 
humble  piety,  of  settled  faith  and  broad  catholicity;  and,  as  I 
think  of  him.  I  see  him  in  the  happy  quiet  of  his  summer  home, 
in  the  early  hours  of  the  Sabbath  morn,  with  his  open  Bible  by 


DR.    AGNEW'S    LATER    LIFE.  297 

his  side,  wherein  for  a  good,  long  hour  ere  I  came  upon  hitn  he 
had  been  reading ;  the  still,  serene  light  of  a  happy,  restiul  soul 
lying  softly  on  his  countenance,  and  the  deep,  calm  joy  of  a 
Christ-kept  spirit  shining  through  his  eyes,  and  the  suggestive, 
quiet  speech  of  a  God-taught  believer  coming  to  me  helpfully 
when  I  entered  on  the  duties  of  the  day. 

"Once  again  I  see  him,  a  sick  and  suffering  man,  leaning 
back,  weak,  in  his  arm-chair ;  lifting  his  wasted  hand  to  take 
mine,  and  raising  his  kindly  eyes  to  me  and  thanking  me  for  a 
simple  prayer  which,  he  said,  'has  done  me  the  most  good,  and 
has  made  my  heart  to  rest.' 

"  Thus  I  bid  him  farewell,  until  the  shadows  flee  away  and 
the  morning  breaks  for  both." 


CHAPTEH  XIII. 

The  Jubilee  of  Dr.  Agnew. 

On  the  lOtli  of  April,  1879,  the  confreres  of  Dr.  Gross,  in 
-commemoration  of  the  fifty-first  year  of  his  entrance  into  the 
profession,  gave  him  a  complimentary  banquet  at  the  St.  George 
Hotel,  at  which  Dr.  Agnew  presided.  The  number  of  sub- 
•scribers  was  limited  to  one  hundred.  Among  the  invited  guests 
were  many  of  the  most  'prominent  surgeons  and  physicians  in 
the  United  States.  The  Committee  on  Arrangements  originally 
consisted  of  Drs.  D.  Hayes  Agnew,  Thomas  G.  Morton,  and 
Richard  J.  Levis,  to  whom  was  afterward  added  Dr.  J.  Ewing 
Mears,  as  Secretary.  The  undertaking  had  its  origin  in  the 
•Surgical  Club  of  Philadelphia,  a  private  association  which  met 
once  a  week  during  the  autumn  and  winter  for  mutual  improve- 
ment and  the  cultivation  of  kindly  feeling.  It  had  been  the 
intention  to  extend  this  compliment  to  Dr.  Gross  the  year  before, 
on  the  occasion  of  his  semi-centennial  professional  birthday,  but 
the  celebration  had  to  be  postponed  on  account  of  the  death  of 
Ms  wife. 

"Professor  Agnew ^  announced  the  first  toast  of  the  evening, 
'  Our  Guest,'  and,  addressing  Dr.  Gross,  indulged  in  the  follow- 
ing eloquent  strain,  which  was  repeatedly  applauded  during  its 
delivery : — 

"The  honor  of  speaking  to  this  toast  devolves  upon  m3'self,  and  I 
ma}^  say  that  it  gives  me  great  pleasure  to  be  the  medium  of  extending 
to  you,  on  this  occasion,  the  friendlj'  congratulations  of  3'Our  profes- 
sional brethren  here  present. 

"Fifty-one  j-ears  is  a  long  time,  my  dear  sir,  for  a  man  to  labor  in 
an}' department  of  knowledge.  Will  3'ou  recall  for  a  moment  just  a  few 
•of  the  events  which  have  transpired  during  this  period  .'*  Two  generations 
have  plnyed  their  part  in  the  great  drama  of  life,  and  have  left  the  stage. 

1  The  remainder  of  the  report  of  this  banquet  is  taken  from  Dr.  Gross'  autobiography. 

(298) 


THE    JUBILEE    OF    DR.    AGNEW.  299 

Dynasties  which  bid  fiiir  to  rival  in  perpetuit\'  that  of  Rome  itself  have 
risen,  flourished,  and  passed  into  decay.  Engineers  iiave  struck  their 
levels,  and  hiid  down  great  iron  roadways  from  one  end  of  this  continent 
to  the  other,  uniting  togetlier  tlie  waters  of  the  Atlantic  and  tlie  Pacific. 
The  most  distant  [)arts  of  tlie  earth  ha\e  Ijeen  reached  by  threads  of  iron, 
over  which  i)ass  the  thoughts  oH  men  in  chariots  of  electric  fire.  The 
tele[)hone  has  made  the  world  a  great  whispering  gallery;  the  powder- 
oart  and  the  sul)tle  arts  of  diplomacy'  have  reconstructed  the  entire  m:ip 
of  Europe;  and  an  American  medical  and  surgical  literature  has  grown 
np  to  which  you  have  been  one  of  the  largest  contributors, — a  literature 
which  is  not  only  read  on  this  side  of  the  Atlantic,  but  in  every  civilized 
countr}'^  on  the  face  of  the  globe.  And  yet  here  you  still  remain,  ni}- 
good  friend,  sturdy  and  strong  as  a  great  oak  of  the  forest;  or,  like 
Moses,  with  eye  undimmed  and  strength  unabated. 

"It  is,  I  fear,  too  commonly  thought,  in  these  days  of  mad  haste 
for  preferment,  place,  or  power,  that  men,  when  they  have  passed  three- 
score and  ten  3ears,  should  gracefully  retire  to  the  shades  of  private  and 
inactive  life,  leaving  the  field  to  younger  athletes. 

"This  is  a  great  mistake.  Look  at  old  Plato,  at  eight3--one,  delv- 
ing away  at  his  studies  with  all  the  enthusiasm  of  yonth  ;  at  Isocrates, 
delivering  his  great  Panathenaic  oration  at  ninety-six.  No,  no  1  There 
is  something  in  the  grace  and  dignity'  of  age.  Its  serene  complacency 
of  mind,  when  coupled  with  an  affluent  wealth  of  knowledge  and  rich 
stores  of  observation  and  experience,  renders  the  presence  of  old  men 
in  our  midst  pillars  of  strength,  not  only  in  a  profession  like  our  own, 
but  to  the  community  at  large  ;  indeed,  to  the  world.  The  Avisdom  of  old 
Pabius  was  more  than  a  matcdi  for  the  trained  legions  of  the  youtliful  and 
wil}'  Hannibal.  It  w:is  not  for  men  like  Milo,  or  Ajax,  for  which  the 
Captain  of  all  the  Gi-eeks  in-nyed,  in  order  that  he  might  humble  the 
proud  battlements  of  Troy,  but  for  men  like  Nestor.  Long  may  you  yet 
live,  my  dear  sir,  actively  to  engage  in  the  duties  of  the  profession  which 
3'ou  have  dignified  and  honored  !  And  when  the  inevitable  hour  comes,  as 
come  it  must  to  each  and  all  of  us, — that  suin-eme  hour,  on  which  all  the 
hours  of  human  life  concentrate, — may  your  eyes  close  on  the  scenes  of 
earth  calm  and  quiet  as  a  summer  evening! 

"It  only  remains  for  me  to  place  on  the  lapel  of  your  coat  this  little 
decoration.  It  is  the  gift  of  the  gentlemen  who  sit  around  this  board. 
And  also  this  book,  whicli  contains  tlie  mimes  of  those  who  i^ai-ticipate  in 
this  interesting  ceremonial.  These  souvenirs  may  serve,  when  you  shall 
have  laid  aside  the  harness  of  conflict,  to  recall  some  })leasant  memories 
of  the  past ;  and  they  may  also  tend  to  fire  the  ambition  of  your  sons  to 
emulate  the  ambition  of  their  noble  sire. 


300  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

"When  Professor  Agnew  had  finished  his  address,  he  at- 
tached to  the  lapel  of  Dr.  Gross'  coat  a  gold  medal,  having  on 
one  side  the  monogram,  'S.  D.  G.,'  in  diamonds  and  brilliants, 
and  on  the  other  this  inscription:  'Presented  to  Dr.  S.  D. 
Gross  by 'his  medical  friends  in  commemoration  of  his  fifty-first 
year  in  the  profession,  April  10,  1879.'  The  memorial  book, 
containing  leaves  of  tinted  paper  on  which  were  written  the 
names  of  the  invited  guests  and  subscribers,  was  presented  at  the 
same  time." 

Nine,  years  later  Dr.  Agnew  celebrated  his  own  jubilee ;  he 
had  graduated  ten  years  later  than  Dr.  Gross,  although  he  was 
thirteen  years  younger.  In  those  nine  years  much  had  hap- 
pened,— Dr.  Gross  had  died ;  Dr.  Agnew  had  given  up  the 
larger  part  of  his  hospital  work ;  he  had  cut  down  his  practice, 
and  was  concluding  arrangements  by  which  to  retire  from  the 
University.  It  was  the  nine  years  filled  with  the  most  momen- 
tous changes  in  his  life. 

As  the  spring  of  1888  approached,  it  was  felt  by  the 
members  of  the  medical  profession  that  some  public  recognition 
should  be  given  Dr.  Agnew  for  the  completion  of  so  long  and 
so  remarkable  a  professional  career,  for  on  a  spring  day  fifty  years 
before  he  had  graduated  from  the  University  of  Pennsylvania. 
For  the  purpose  of  carrying  out  this  intention,  a  preliminary 
meeting  was  held  in  the  Council-room  of  the  College  of  Phy- 
sicians, Tuesday,  January  31st.  This  preliminary  call  was 
signed  by  Drs.  S.  Weir  Mitchell,  Ellwood  Wilson,  John  H. 
Brinton,  J.  Solis  Cohen,  J.  M.  Da  Costa,  William  Pepper, 
James  H.  Hutchinson,  and  Thomas  J.  Yarrow.  At  this  meet- 
ing, held  January  31,  1888,  on  motion  of  Dr.  S.  W.  Gross,  Dr.  S. 
Weir  Mitchell  was  chosen  chairman  of  the  meeting,  and  Dr. 
Horace  Y.  Evans  secretary.  Dr.  H.  C.  Wood  moved  that  the 
form  of  the  testimonial  be  a  public  reception ;  Dr.  John  Ash- 
hurst,  Jr.,  amended  the  motion,  with  the  suggestion  that  it  be 
made  a  banquet  by  the  members  of  the  medical  profession,  which 
was  adopted  by  vote.     It  was  decided,  therefore,  that  a  dinner 


THE   JUBILEE    OF    DR.    AGNEW.  301 

be  given  to  Dr.  Agnew,  tlic  subscription  being  fixed  at  twelve 
dollars,  two  dollars  of  which  and  the  balance  tliat  might  remain 
after  the  dinner  to  be  used  in  procuring  an  oil  portrait  of  Dr. 
Agnew,  to  hang  in  the  hall  of  the   College  of  Physicians. 

A  Committee  of  Arrangements  of  twelve  was  appointed, 
which  consisted  of  Drs.  J.  M.  Da  Costa,  EUwood  Wilson, 
Owen  J.  Wister,  llichard  A.  Cleeman,  J.  Solis  Cohen,  Alfred 
Stille,  John  Ashhurst  (Jr.),  William  F.  Norris,  Samuel  W.  Gross, 
Lewis  Rodman,  William  Pepper,  James  H.  Hutchinson,  and 
S.  Weir  Mitchell.  Dr.  J.  M.  Da  Costa  was  appointed  Chairman 
of  this  Committee. 

Dr.  Agnew  accepted  the  invitation  of  the  committee,  leaving 
the  date  of  the  dinner  to  be  fixed  by  them.  The  committee  ac- 
cordingly selected  the  6th  of  April  as  the  most  appropriate  date 
for  the  banquet.  At  its  meeting  on  March  3d  the  committee 
approved  a  list  of  physicians  to  be  invited  to  subscribe  to  the 
celebration  in  Philadelphia.  It  was  decided  that  the  physicians 
outside  of  Philadelphia  to  be  invited  to  subscribe  be  limited  to 
those  living  in  towns  in  neighboring  States,  within  a  radius 
of  forty  miles  of  Philadelphia.  It  was  resolved  that  certain 
physicians  from  other  cities  be  invited  as  guests,  as  reported 
by  the  same  committee.  This  list  was  afterward  revised  by 
Dr.  Agnew. 

The  banquet  was  confined  entirely  to  medical  men,  with 
two  exceptions,  these  being  the  pastor  of  Dr.  Agnew's  church, 
Hev.  Dr.  John  S.  Macintosh,  and  his  cousin,  Rev.  Dr.  Benjamin 
L.  Agnew.  More  than  two  hundred  physicians  promptly 
accepted  the  invitation  of  the  committee,  and  the  banquet  took 
place,  on  the  evening  of  the  appointed  day,  in  tlie  foyer  of  the 
Academy  of  Music.  One  table  was  placed  parallel  with  the 
northern  wall,  at  which  sat  the  chairman  of  the  committee,  Dr. 
J.  M.  Da  Costa,  with  the  honored  guest  of  the  evening,  Dr. 
Agnew,  on  his  right,  and  the  Rev.  Dr.  Macintosh  on  his  left. 
Three  long  tables  at  right  angles  to  this  reached  nearly  to  the 
southern  end  of  the  room. 


302  LIFE    OF    D.    HATES    AGNE\^,    M.D.,    LL.D. 

At  no  period  in  his  life  was  there  a  greater  display  of  the 
magnetism  which  surrounded  Dr.  Agnew's  personal  presence. 
His  modest  manner  only  seemed  to  heighten  the  enthusiasm  and 
love  lavished  upon  him  hy  his  colleagues  and  former  students. 
These  characteristics  brought  out  one  of  the  most  curious  feat- 
ures of  the  success  of  Dr.  Agnew, — the  remarkable  lack  of  ill 
feeling  and  jealousy  which  surrounded  his  advance.  Although 
the  attendance  at  the  banquet  was  made  up  largely  of  his  life- 
long associates  in  the  medical  profession,  there  was  no  one  to 
begrudge  his  honors  or  belittle  his  fame.  It  was  demon- 
strated to  the  public  again  that  Dr.  Agnew  was  truly,  as  was 
said  of  him  later,  "the  doctors'  doctor." 

The  opening  speech  of  the  evening  was  made  by  Dr.  J.  M. 
Da  Costa,  who  proposed  the  toast,  "  The  Honored  Guest  of  the 
Evening."     He  spoke  as  follows  : — 

Fifty  years  ago,  on  this  veiy  day,  there  stood,  with  the  honors  of 
a  Universit}'  just  received,  a  3'oung  man  on  the  threshold  of  his  life. 
His  thoughts  were  the  pleasant  ones  of  the  occasion  ;  his  aspirations  had 
hardly  taken  shape;  he  was  the  popular  comrade  of  the  one  hundred 
and  fifty-five  whose  real  life,  like  his  own,  was  to  begin.  Fifty  years 
have  passed,  and  their  Agnew  has  become  our  Agnew,  of  the  many 
thousands  of  the  medical  profession. 

Honored  Guest :  In  addressing  you  to-night  I  feel  that  I  speak  not 
simply  for  those  who  are  gathered  around  you,  nor  for  those  in  this 
Commonwealth  whose  interests  will  centre  here,  but  for  the  whole  pro- 
fession, who  hold  you  in  sucli  esteem,  and  whose  sympathetic  thoughts, 
could  the}"  reach  you,  would  come  to  you  in  messages  of  such  good  will 
and  artection  as  to  overwhelm  3'ou  witli  their  warmth. 

Your  career  has  been  indeed  a  remarkable  one,  and  you  must  pardon 
me  and  let  the  occasion  be  my  excuse  if  in  3'our  presence  I  allude  to  its 
success  and  the  main  causes  of  that  success.  Nor  is  it  wholly  unfitting 
in  one  to  do  so  who  lias  known  you  and  watched  3'our  progress  with 
friendly  interest  almost  since  3'ou  came  to  this  cit}'  to  try  your  powers 
in  a  wider  field.  The  training  you  brought  with  you  as  a  rural  practi- 
tioner of  note  was  indeed  valuable.  Self-reliance  and  cool  judgment  under 
difficult  circumstances  are  not  the  least  reward  of  a  country  physician's 
hard  life. 

You  enrolled  yourself  as  a  teacher  of  medicine  in  its  most  labori- 


THE    JUBILEE    OF    DR.    AGNEW.  303 

ons  branch,  and  fittingly  took  charge  of  a  school  which  has  been  the 
nursery'  of  famous  anatomists  and  surgeons, — where  Godman's  })rac- 
tical  skill  was  displayed,  and  Joseph  Pancoast  laid  the  foundation  of  that 
intimate  kuovvledge  of  the  human  frauie  wliich  made  him  afterward  so 
great  a  surgeon. 

The  Philadelphia  School  of  Anatomy,  in  College  Aveuue,  has,  in- 
deed, left  its  mark  in  the  history  of  medicine.  It  has  been  to  us  what 
the  Windmill  Street  Sciiool  was  to  London,  of  William  and  John  Hunter, 
of  Hewson,  of  Cruiksliank,  of  Baillie,  of  Benjamin  Brodie,  of  Charles 
Bell.  Its  rickety  structure  harbored  not  only  anatomists, — some  of 
them  your  own  pupils,  who  are  to  succeed  you  as  celebrated  teachers, — 
but  its  dingy  walls  heard  eloquent  discourses  on  diverse  branches  from 
more  than  one  of  your  future  colleagues.  In  its  garret,  independent  and 
fruitful  researches  on  the  textures  of  the  bod}'  were  pursued  ;  in  its 
cramped  lower  room,  physiological  experiments  were  carried  on,  which 
have  made  their  deep  impress  on  the  science  of  our  day. 

For  ten  years,  workiug  in  this  school  of  anatomy,  3'ou  lived  labor- 
ious days  and  nights,  and  in  its  stern  training  your  classes  grew  until 
the  narrow  quarters  would  hold  them  no  more,  and  j^ou  became  the 
popular,  admirable  teacher  you  have  proved  yourself  on  a  larger  scale 
and  on  a  different  branch,  as  professor  of  the  principles  and  practice  of 
surgery  in  the  famed  University  with  which  your  reputation  is  forever 
identified. 

You  learned  to  present  facts  plainly  and  impressivel}',  to  teach 
nature's  truths  with  nature's  simplicity,  and  without  a  deadly  paral- 
ysis of  words.  But  in  these  ten  years  of  unremitting  work  you  did 
something  more  than  teaching, — you  laid,  b^'  exact  knowledge,  by  steadi- 
ness of  purpose  and  affability,  the  foundations  of  that  large  practice 
which  you  have  since  enjoyed,  developing  more  ever^'  day  into  the 
trusted  surgeon,  whose  deft  hand  and  cool  judgment  caused  his  advice 
to  be  generally  sought. 

You  have  been  tried  in  many  a  hard  case  ;  in  none  harder  than  when 
3''0ur  reputation  caused  you  to  be  selected  among  the  counselors  at  the 
couch  of  that  wounded  one  for  whose  relief  millions  were  anxiously  watch- 
ing. That  in  these  trying  times  you  bore  yourself  with  the  same  calm- 
ness and  dignit}' we  know  in  .you,  ever}' one  in  these  millions  recognized. 

Your  success  as  a  surgeon  of  great  repute  must  indeed  have  been 
gratifying  to  you  ;  not  only  for  the  opportunities  it  afforded  you  of 
doing  so  much  active  work  in  your  profession,  not  only  because  it  gave 
a  personal  value  to  your  writings,  especially  to  your  opinions  expressed 
in  your  elaborate  work  on  surgery,  but  because  it  enabled  you  to  carry 
out  a  plan  of  action  of  which  I  may  not  speak, — one  which  showed  j'ou 


304  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

to  be  possessed  of  tlie  same  high  sense  of  honor  for  which  Sir  Walter 
Scott  has  received  the  unbounded  admiration  of  mankind. 

May  you,  dear  sir,  who  have  these  many  claims  to  distinction  and 
esteem  ;  may  you  on  this  the  fiftieth  anniversary'-  of  entrance  into  a  pro- 
fession which  you  liave  graced  by  your  industry,  your  sagacity,  your 
skill,  your  character ;  ma}'  you  accept  the  homage  of  those  who  are 
engaged  with  a'ou  in  the  same  pursuit,  as  a  sign  of  widel3'-felt  regard  and 
appreciation.  Ma}^  your  vigorous  frame  preserve  jouv  power  of  doing 
good,  of  teaching  truths,  for  manj^  a  long  year.  May  there  always  re- 
main with  you  the  assurance  that,  as  age  gently  la3^s  its  hand  upon  you, 
the  chilling  finger  of  time  will  not  lessen  tlie  respect  nor  benumb  the 
tenderness  of  feeling  with  which  3'oung  and  old  alike  regard  j-ou. 

At  the  close  of  the  speech  by  Dr.  Da  Costa  there  was  great 
cheering  for  some  time,  and,  quiet  finally  being  restored,  Dr. 
Agnew  arose.  This  movement  was  greeted  with  enthusiastic 
cheers.      He  said  : — 

Mr.  Chairman:  When  I  glance  over  this  table  and  see  so  manj^ 
distinguished  and  representative  men,  of  my  own  profession,  who  have 
come  to  do  honor  to  one  of  the  humblest  of  their  guild,  I  confess  it  is 
with  a  deep  sense  of  embarrassment  that  I  wish  to  respond  to  the  com- 
plimentary sentiment  embodied  in  3'our  toast  and  in  your  address.  I  can 
sa}',  without  affectation,  that,  had  it  been  tlie  pleasure  of  my  friends,  a 
less  conspicuous  demonstration  of  their  good-will  than  the  present 
would  have  been  more  in  consonance  with  my  feelings  and  taste. 

It  is  a  great  distinction  for  anv  man,  in  whatsoever  sphere  of  life 
he  may  move,  to  win  the  confidence  and  esteem  of  his  fellows.  And  it  is 
scarcel}''  necessarj^  for  me  to  say  how  profoundly  I  realize  this  mark  of 
your  respect. 

Any  man  who  has  lived  long  in  this  world,  and  has  taken  a 
thoughtful  retrospect  of  his  past  life,  must  be  forced  to  confess  that 
the  influences  and  forces  which  liave  conspired  to  mould  his  character  and 
to  shape  his  destin}',  are  most  mysterious  indeed.  Plans  constructed 
with  infinite  care  have  miscarried;  fondlj'-cherished  hopes  have  been 
suddenly'  crushed  with  a  shock;  glowing  anticipations,  just  about  to  be- 
come realizations, are  dissipated  in  a  moment  into  thin,  A'iewless  air,  like 
earth-mists  before  the  morning  sun.  One  of  Scotland's  gifted,  but 
unfortunate    sons,  has    condensed    these    thoughts  into    the   expressive 

couplet : — 

"  The  best  laid  schemes  o'  mice  and  men 
Gang  aft  aglee." 


THE   JUBILEE    OF    DR.    AGNEVT.  305 

And  the  great  bard  of  England — rather,  the  bard  of  all  people 
and  all  times — has  crystallized  the  same  sentiment  in  those  expressive 

lines : — 

"  Tliere  is  a  divinity  tliat  sliapes  our  ends, 
Rough  hew  tiiem  as  we  may." 

And  a  greater  than  either  has  said  :  ''  It  is  not  in  man  to  direct 
liis  steps." 

About  tliirty-five  years  ago,  I  came  to  this  city  a  stranger. 
Although  previously  enjoying  a  large  practice  in  a  wealthy  and  populous 
district,  yet  the  field  was  never  a  satisfactory  one.  The  horizon  seemed 
too  contracted,  the  prospect  uninviting.  Possessing  naturally  strong 
anatomical  taste,  I  was  able  to  ratif}'  these  onlj'  to  a  moderate  degree, 
b^^  dissections  of  the  human  body  and  the  bodies  of  animals;  the  preju- 
dice against  studies  of  this  nature  was  calculated  to  render  their  prosecu- 
tion unpopular,  not  to  say  very  embarrassing.  The  desire,  therefore,  to 
obtain  a  larger  field  for  the  gratification  of  the  idol  of  my  thoughts 
induced  me  to  make  Philadelphia  my  home. 

The  scene  of  my  early  labors,  as  most  of  yon  know,  was  in  Col- 
lege Avenue,  in  the  Philadelphia  School  of  Anatomy.  This  institution 
— not  a  chartered,  but  a  private  one — had  both  an  ancient  and  an  hon- 
orable history.  It  was  here  that  Godman  and  Webster  and  the  elder 
Pancoast  and  Allen  laid  the  foundation  of  their  reputation.  It  was,  in- 
deed, a  school  of  the  prophets;  a  gymnasium  in  which  were  trained  the 
great  majority  of  the  men  who,  as  teachers  and  writers,  have  filled  so 
large  a  place  in  the  medical  world.  Among  these  names  may  be  men- 
tioned that  of  Gerhard,  the  pioneer  of  physical  diagnosis  in  America; 
of  Wallace,  who  became  Professor  of  Obstetrics  in  the  Jefferson  Medical 
College;  of  Bridges,  Professor  of  Chemistry  in  the  Philadelphia  School 
of  Pharmacy  ;  of  Keating,  elected  Professor  of  Obstetrics  in  Jefferson 
College,  but  compelled  to  resign  on  account  of  ill  health  ;  of  Henry  H. 
Smith,  Professor  of  Surgery  in  the  Universitj'  of  Pennsylvania;  of 
Francis  Gurney  Smith,  Professor  of  F^hysiology  in  the  same  institution  ; 
of  your  honored  chairman,  Professor  of  the  Principles  and  Practice  of 
Medicine  in  the  Jefferson  Medical  College ;  of  Penrose,  Professor  of 
Obstetrics  in  the  University  of  Pennsylvania;  of  Brinton,  one  of  the 
Professors  of  Surgery  in  the  Jefferson  Medical  College;  Garretson,  the 
author  of  a  popular  work  on  "  Oral  Surgery  "  ;  and  of  Keen,  Professor  of 
Surgery  in  the  Women's  College  of  Philadeli)hia.  It  was  here  that 
Brown-Sequard  delivered  his  lectures  on  operative  physiology,  and  it  was 
here  that  Mitchell  conducted  his  classic  experiments  on  snake-poison,  and 
on  many  physiological  problems,  whicii  have  placed  his  name  alongside 
that  of  Ferrier  and  given  him  a  high  place  among  the  scientists  of  the 


306  LIFE    OF    D.    HAYES    AGNEV7,    M.D.,    LL.D. 

present  daj-.  It  was  in  this  iiistitutiLU  that  for  many  3'ears,  summer  and 
winter,  night  and  day,  rarel}'  taking  a  vacation,  I  studied  tlie  m3'steries 
of  this  wonderful  organism  of  ours,  with  a  love  and  a  zeal  which  never 
flagged,  and  drew  around  me,  notwithstanding  the  hostility  of  the 
two  great  medical  schools,  from  a  small  beginning  of  nine  medical  stu- 
dents, the' largest  private  classes — only  limited  Ly  the  capacity  of  the 
building — tliat  had  ever  followed  a  private  teacher  in  this  country. 

Those  were  happ_y  days:  yes,  I  think  the  happiest  daj^s  of  m3^  life. 
I  was  master,  then,  of  my  own  kingdom.  Those  old,  dingy  rooms  had 
more  attractions  for  me  than  the  frescoed  and  fretted  walls  of  a  palace, 
and  tliose  anatomical  odors  were  sweeter  far  tlian  those  of  Arabj^  the 
blest. 

When  I  was  induced  to  accept  the  demonstratorship  of  Anatom}'' 
in  the  University'  of  Pennsylvania,  it  was  witli  reluctance  and  regret  that 
I  left  the  old  Philadelphia  School  of  Anatom3\  It  was  entirel3'  natural 
that  my  thoughts  should  linger  al)out  College  Avenue,  for  it  was  here 
that  I  formed  tliose  friendships  wliich,  like  hooks  of  steel,  have  bound 
me  to  the  medical  men  of  ever3'  part  of  this  countr3%  and  to  not  a  few 
across  tlie  sea. 

In  1854  a  nnited  effort  was  made  to  reopen  the  Philadelphia  Hos- 
pital for  medical  teaching.  The  doors  of  this  institution  had  been 
closed  for  several  years.  History  furnishes  innumerable  instances  in 
which  the  most  momentous  events  have  been  determined  b3^  the  most 
trivial  accidents.  All  these  fade  into  insignificance  when  contrasted  with 
that  which  closed  the  doors  of  this  great  clinic  against  the  profession. 
The  cackle  of  a  few  geese  saved  Rome,  Ijut  a  presumptuous  cockroach 
closed  the  gates  of  tiie  Blockley  Hospital  to  clinical  teachings.  Let  me 
say  here  in  parenthesis,  that  to  Dr.  Henry  H.  Smith  and  Dr.  J.  L.  Ludlow, 
more  than  to  all  others  combined,  the  profession  and  the  countr3'  at 
large  are  indebted  for  the  restoration  of  this  important  hospital  to  clin- 
ical instruction.  B3'  their  unwearied  and  indefatigable  perseverance,  bj' 
their  unceasing  importunity,  like  tlie  widow  with  the  unjust  judge,  these 
men  succeeded  in  revolutionizing  tlie  antagonistic  and  settled  ideas  of 
the  Board  of  Guardians,  and  gained  this  great  contest.  On  the  same 
day  that  the  Hospital  Committee  made  their  favorable  repoi't,  Dr.  Smith 
and  I  were  elected  surgeons  in  the  institution,  and  for  twelve  3'ears,  save 
for  a  short  interregnum,  when  self-respect  demanded  the  resignation  of 
the  Medical  Board,  I  continued  to  discharge  the  duties  of  a  clinical 
teacher  of  surgery  in  the  hospital.  In  1864  I  was  elected  one  of  the 
surgeons  to  the  Wills  Hospital  for  Diseases  of  the  E3'e, — fulfilling  the 
duties  of  the  physician  for  a  period  of  six  years.  In  1865  I  was  hon- 
ored by  an  appointment  on  the  surgical  staff  of  the  Penns3'lvania  Hos- 


THE    JUBILEE    OF    DK.    AGNEW.  307 

pital,  and  for  about  eleven  3ears  continued  my  service  in  that  venerable 
institution  until  the  inauguration  of  a  policy  which  compelled  me  to 
resign. 

Let  me  say  here  that  I  have  tried  to  make  it  a  rule  of  my  life 
never  knowingly  to  violate  my  sense  of  duty.  And,  with  the  help  of 
God's  grace,  it  has  never  cost  me  one  moment's  hesitation  to  turn  my 
back  on  any  i)roposition  or  place,  however  tempting,  the  acceptance  of 
which  would  compel  me  to  surrender  my  conscientious  conviction  of 
right. 

In  1877  the  Board  of  Managers,  of  its  own  motion  and  unso- 
licited, with  a  cordialit}'  and  unanimity'  which  I  can  never  forget, 
re-elected  me  to  my  former  place  on  the  surgical  staff.  In  1867  I  was 
elected  one  of  the  siu-geons  to  the  Orthopedic  Hospital,  then  situated 
on  Ninth  Street,  which  has  now  grown  to  be  one  of  the  important 
institutions  of  tlie  countrj^  for  tlie  treatment  of  deformities.  In  1870 
the  Trustees  of  the  University  of  Pennsylvania  elected  me  to  the  Chair 
of  Clinical  Surger3^  in  that  institution,  and  a  3'ear  later  to  the  Chair  of 
the  Princi[)les  and  Practice  of  Surgery,  and  on  the  completion  of  tlie 
University  Hospitsd  Building  I  was  appointed  one  of  the  clinical  pro- 
fessors of  surgery. 

Whj'^  I  should  have  all  these  honors  thrust  upon  me  I  do  not  know. 
(A  voice :  "We  know.")  Other  and  abler  men  could  have  filled  them. 
But  this  much  I  can  say, — I  never  schemed  or  planned  for  one  of  them. 
An}^  place  in  the  rei)ublic  of  medicine  was  honorable  enough  for  me. 
I  knew  there  were  golden  apples  in  the  garden  of  the  Hesperides,  but 
I  was  too  much  in  love  with  my  own  particular  study  to  attempt  to  pla}'" 
Hercules  and  the  Dragon. 

M}'  love  for  the  profession  was  inborn,  M'rought  into  the  verj'  fibre 
of  my  mental  organization,  and  inspired  not  b}^  the  honors  at  her  com- 
mand, but  from  the  unspeakable  satisfaction  and  pleasure  of  being  able 
to  iise  her  resoui'ces  for  the  benefit  of  our  common  humanit}'.  How 
long  I  may  be  able  to  continue  in  this  service  I  know  not.  This  I  leave 
to  the  wisdom  of  Him  who  numbers  the  hairs  of  the  head  and  notes  the 
flight  or  tlie  fall  of  the  sparrow  ;  but,  come  when  that  supreme  moment 
must,  I  shall  be  satisfied.  I  have  had  all  that  I  could  wish, — more  than 
I  deserve. 

And  now,  gentlemen,  this  is  a  great  honor  which  vou  have  done 
me;  to  be  the  guest  of  such  a  company  siionld  satisfy  tiie  most  exacting 
ambition.  And  let  me  say,  to  each  and  ail  of  my  professional  brethren 
here  to-night,  that  I  have  no  words  wliich  can  fittingly  express  the  pro- 
found obligation  under  whicli  I  am  placed  by  your  generosity  and  kind- 
ness. 


308  LIFE    OF    D.    HAYES    AGSEW.    M.D..    LL.D. 

Dr.  Lewis  A.  Sayre,  of  Xew  York,  being  called  upon  by 
Dr.  Da  Costa,  spoke  as  follows,  in  response  to  tlie  toast,  "  Our 
Invited  Guests  "  : — 

Mk.  Chairman  and  Gentlemen:  I  veiy  fulh' appreciate  the  dis- 
tinguislied  honor  conferred  upon  me  by  being  requested  to  respond  to 
the  toast  of"  Our  Invited  Guests  "  on  this  momentous  occasion,  when  we 
have  assembled  to  commemorate  the  fiftieth  annivei^ar^^  of  the  pro- 
fessional life  of  one  of  America's  greatest  living  surgeons.  Dr.  D.  Hayes 
Agnew.  I  most  sincere}}'  regret  that  some  one  more  worthy,  or  at  least 
more  competent,  had  not  been  selected  to  perform  this  pleasant  duty. 

There  is  no  physician — and  particnlarly  no  surgeon — in  the  broad 
expanse  of  this  whole  country  who  woiild  not  most  thankfully  embrace 
the  opportunity  of  adding  his  leaf  to  the  "  laurel  crown  "  so  richly  earned 
by  our  distinguished  friend,  and  which,  to-uight,  we  so  cheerfulh' accord 
to  him. 

Wh}-  is  it  that,  without  a  single  dissenting  voice,  the  entire  pro- 
fession of  this  vast  countr}"  unite  in  harmony  with  us  in  doing  honor  to 
Dr.  Agnew?  Many  others  have  lived  and  practiced  the  profession  for 
more  than  fifty  years,  and  3-et  have  not  been  singled  out  for  this  distinc- 
tion. Why  is  it.  then,  that  this  large  gathering  of  tlie  most  distinguished 
members  of  our  profession,  and  from  the  most  dista^nt  sections  of  our 
vast  territor}',  has  assembled  here  to-night  to  do  him  lionor? 

It  is  because  of  his  pure  and  unsullied  life,  his  strict  integrity, 
his  close  and  constant  devotion  to  the  impi'ovement  of  surgical  science, 
his  careful  and  conscientious  investigation  of  all  new  suggestions,  and 
his  ready  approval  and  adoption  of  all  such  as  he  could  prove  to  be  true, 
after  such  investigation. 

Another  great  charm  of  his  diaracter — and  which  has  endeared 
him  to  so  many — is  his  earnest  desire  to  impart  to  others  all  the  infor- 
mation that  he  had  obtained  himself  by  diligent  and  careful  application. 
And  he  thus  became  the  disseminator  of  important  knowledge  to  the 
thousands  of  students  who  listened  with  rapture  to  his  eloquent  and  in- 
structive teachings. 

This  is  not  the  fitting  time  nor  place  to  review  in  detail  the  immense 
improvements  —  in  fact,  I  might  almost  say  the  marvelous  improve- 
ments— that  have  been  made  in  the  science  and  practice  of  surgery' 
within  the  past  half-century.  Yet.  I  cannot  refrain  from  brieflj-  refer- 
ring to  a  few. 

Take,  for  instance,  the  cases  of  compound  comminuted  and  com- 
plicated fractures  that  were  formerly  condemned  to  amputation,  and 
that  are  now  successfully  treated,  resulting,  in  man}'  instances,  in  useful 


THE   JUBILEE    OF    DR.    AGNEW.  309 

limbs  find  also  in  moviible  joiuts.  Wounds  and  injuries  of  the  intes- 
tines, bladder,  kidney,  livei',  and  even  of  the  stomach,  which  were  for- 
merly considered  necessarily  fatal,  are  now,  by  proper  antiseptic  precau- 
tions, snccessfuUy  treated,  and,  in  man}^  instances,  with  rai)id  recovery, 
without  any  constitutional  disturbance,  or  even  the  formation  of  a  drop 
of  pus.  The  exact  localization  and  successful  removal  of  tumors  and 
abscesses  of  the  brain;  the  union  of  all  wounds  b}' first  intention,  under 
proper  antiseptic  ))recautions, — these  are  some  of  the  marvelous  advances 
in  surgery  which,  had  they  been  described  fifty  years  ago,  would  not  have 
been  believed. 

But  our  distinguished  friend,  in  whose  honor  we  are  assembled 
here  to-night,  has  kept  himself  well  abreast  with  all  these  recent  im- 
provements, and  taught  his  recent  classes  the  exact  science  of  surgerj', 
as  understood  and  practiced  at  the  present  time. 

His  has  been  a  great  gift, — the  gift  of  the  mastery  of  the  mystery 
of  healing;  the  wielding  of  the  necromancer's  wand  over  bodil}-  de- 
formity and  suffering ;  and  the  still  greater  gift,  the  abilit}'  to  impart 
to  others,  through  his  instructive  teachings,  the  knowledge  he  himself 
possessed. 

Our  Divine  Master,  who  commanded,"  Visit  the  sick  in  their  afflic- 
tions," He  who  made  the  blind  to  see,  the  lame  to  walk,  the  deaf  to  hear,  the 
dumb  to  speak,  appears  in  this  capacit}^  in  His  very  sublimest  character, 
that  of  the  "  Great  Physician," — the  ideal  Christ, — Christ,  the  healer. 

And  surely,  no  other  comes  quite  so  near  the  great  exemplar  of 
Christianity^  as  he  who  most  successfull}'  relieves  human  afflictions. 

This,  so  far  as  I  understand  the  character  of  Dr.  Agnew,  has  been 
the  principal  or  leading  object  of  his  life  for  the  past  f\\'ly  3'ears. 

Let  ns  all  imitate  his  noble  example. 

Dr.  S.  Weir  Mitchell  then  read  a  poem  in  honor  of  the 
occasion.     It  was  as  follows : — 

Poem  hy  Dr.  Mitchell.     Read  at  the  Dinner  Commemorative  of  the 
Fiftieth  Year  of  the  Doctorate  of  D.  Hayes  Agnew,  3LD., 
April  6,  1888. 
Good  Chairman,  Brothers,  Friends,  and  Guests, 

all  ye  who  come  with  praise 
To  honor  for  our  ancient  guild  a  life  of  blameless  days, 
If  from  the  well-worn  rond  of  toil  I  step  aside  to  find 
A  poet's  roses  for  the  wreath  your  kindly  wishes  bind, 
Be  certain  that  their  fragrance  types,  amid  j'our  laurel-leaves, 
The  gentle  love  a  tender  heart  in  dut3''s  chaplet  weaves. 


310  LIFE    OF    D.    HATES    AGNEVT.    M.D..    LL.D. 

I  can't  exactly  set  the  date. — the  Chajrman,  be  'will  know. — 

But  it  was  on  a  chilly  night,  some  month  or  two  ago. 

Within,  the  back-log  warmed  my  toes;  without,  the  frozen  rain, 

Storm-driven  by  the  augrj-  wind,  clashed  on  my  window-pane. 

I  lit  a  pipe,  stirred  up  tlie  fire,  and,  dry  with  thirst  for  knowledge, 

PI  untied  "headlong  in  an  essay  by  a  Fellow  of  the  College. 

But,  sir,  I've  often  seen  of  late  that  this  especial  thirst 

Is  not  of  all  the  A-aried  forms  the  keenest  nor  the  worst. 

At  all  events,  that  gentleman, — that  pleasant  College  Fellow, — 

He  must  have  been  of  all  of  us  the  juiciest  and  most  mellow. 

You  ask  his  name,  degree,  and  fame;  j^ou  want  to  know  that  rare 

man  ? 
It  wasn't  yon. — nor  you, — nor  30U  ; — no,  sir,  'twas  not  the  Chairman  ! 

For  minutes  ten  I  drank  of  him,  quenched  was  my  ardent  thirst, 

Another  minute,  and  my  veins  with  knowledge,  sir,  had  burst ; 

A  moment  moi-e,  my  head  fell  back,  my  laz^'^  eyelids  closed. 

And  on  mv-  lap  that  Fellow's  book  at  equal  peace  reposed. 

Then  1  remember  me  the  night  that  essaj'  first  was  read, 

And  how  we  thought  it  couldn't  all  have  come  from  one  man's  head. 

At  nine  the  College  heard  a  snore  and  saw  the  Chairman  start, — 

A  snore  as  of  an  actor  shj'  rehearsing  for  his  part. 

At  ten,  a  shameless  chorus  around  the  hall  had  run, 

The  Chairman  dreamed  a  feeble  joke,  and  said  the  noes  had  won. 

At  twelve  the  Treasurer  fell  asleep,  the  wakeful  Censors  slumbered, 

The  Secretary's  minutes  grew  to  hours  quite  unnumbered. 

At  six  A.M.  that  Fellow  paused,  perchance  a  page  to  turn. 

And  up  I  got,  and  cried,  '■  I  move  the  College  do  adjourn." 

They  didn't,  sir ;  they  sat  all  day.  .  It  made  my  flesh  to  creep. 

All  night  they  sat ;  that  couldn't  be.     Goodness  !  was  I  asleep? 

Was  I  asleep  ?     With  less  effect  that  Fellow  might  have  tried 

Codeia,  Morphia,  Urethan,  Chloral,  Paraldehyde. 

In  vain  my  servant  called  aloud,  "  Sir,  here's  a  solemn  letter 

To  say  they  want  a  song  from  you,  for  lack  of  some  one  better. 

The  Chairman  says  his  man  will  wait  while  you  sit  down  and  write; 

He  says  he's  not  in  any  haste, — and  make  it  something  light; 

He  says  ^-ou  needn't  vex  yourself  to  try  to  be  eff'ulgent. 

Because,  he  says,  champagne  enough  will  keep  them  all  indulgent." 

I  slept — at  least  I  think  I  slept — an  hour  by  estimation, 
But,  if  I  slept,  I  must  have  had  unconscious  cerebration  ; 
For  on  my  desk,  the  morrow  morn,  I  found  this  ordered  verse : 
Pray  take  it  as  you  take  your  wife. — "  for  better  or  for  worse." 


THE    JUBILEE    OF    DU.    AGNEW.  311 


MINERVA    MEDICA. 

A  golden  wedding;  fifty  earnest  years 

This  si)ring-tide  day  from  that  do  sadly  part, 

"When,  'mid  a  learned  throng,  one  shy,  grave  lad, 
Ualf  conscious,  won  the  Mistress  of  our  Art. 

Still  at  his  side  the  tranquil  goddess  stood, 
Unseen  of  men,  and  claimed  the  student  boy. 

Touched  with  her  cool,  sweet  lips  his  ruddy  cheek, 
And  bade  him  follow  her  through  grief  and  joy. 

"  Be  mine,''  she  whispered  in  his  startled  e;ir, 
"  Be  mine  to-day,  as  Pare  once  was  mine  ; 
Like  Hunter  mine,  and  all  who  nobly  won 
The  fadeless  honors  of  that  shining  line. 

"  Be  mine,"  she  said,  "  the  calm  of  honest  eyes. 
The  steadfast  forehead,  and  the  constant  soul, 
Mine,  the  hrm  heart  on  simple  duty  bent. 
And  mine  the  manly  gift  of  self-control. 

"  Not  in  my  service  is  the  harvest  won 

That  gilds  the  child  of  barter  and  of  trade  ; 
That  steady  hand,  that  ever-i)itying  touch, 
Not  in  my  helping  shall  be  thus  repaid. 

"  But  I  will  take  you  where  the  great  have  gone, 
And  I  will  set  your  feet  in  honor's  w:iys  ; 
Friends  I  will  give,  and  length  of  crowded  years, 
And  crown  your  manhood  with  a  nation's  praise. 

"  These  will  1  give,  and  more;  the  poor  man's  home, 
The  anguished  sufferer  in  the  clutch  of  pain, 
The  camp,  the  field,  the  long,  sad,  waiting  ward, 
Watch  for  your  kindly  face,  nor  watcii  in  vain 

"  For,  as  the  sculptor  years  shall  chisel  deep 
The  lines  of  pity  'neath  the  brow  of  thought, 
Below  your  whitening  hair  the  hurt  shall  read 

How  well  you  learned  what  I  my  best  have  taughtl" 

The  busy  footstei)s  of  your  toiling  stand 
Upon  the  noisy  century's  sharp  divide. 

And  at  your  side,  to-night,  I  see  her  still. 

The  gracious  woman,  strong  aiul  tender-eyed. 


312  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

O,  statelj^  Mistress  of  our  sacred  Art, 

Changeless  and  beautiful,  and  wise  and  brave, 

Full  fifty  years  have  gone  since  first  3-our  lips 
To  noblest  uses  pledged  that  forehead  grave. 

As  round  the  board  onr  merry  glasses  rang. 
His  golden-wedding  chimes  I  heard  to-night ; 

We  know  its  offspring ;  in  a  hundred  towns 
His  pupil  children  bless  his  living  light. 

What  be  the  marriage-gifts  that  we  can  give  ? 

What  lacks  he  that  on  well-used  years  attends  ? 
All  that  we  have  to  give  are  his  to-day, — 

Love,  honor,  and  obedience,  troops  of  friends. 

The  reading  of  this  poem  was  followed  by  an  address  by 
Dr.  R.  A.  Cleeman,  to  whose  energies  much  of  the  success  of 
the  banquet  was  due.  Dr.  Cleeman  made  a  brief  but  eloquent 
speech  preceding  his  formal  motion  to  adjourn,  which  was  after- 
ward withdrawn,  at  the  request  of  the  Chairman,  Dr.  Da  Costa, 
to  give  Dr.  Thomas  Wistar  an  opportunity  to  read  his  verses 
written  in  honor  of  the  guest  of  the  evening: — 

Ode  to  Professior  D.  Hayes  Agnew,  31. D.,  LL.D.,  on  the  Fiftieth  Anni- 
versary of  Ms  Graduation  in  Medicine,  April  6,  18S8. 
By    Thomas  Wistar,  M.D. 

The  winter  whiteness  glorifies  thy  brow, 

The  summer  sunshine  lingers  on  thy  face  ; 
Upon  thy  heart  the  j-ears  have  left  no  trace, 
Warm  as  it  kindled  first,  we  feel  it  now. 

Here  age  and  youth  alike  before  thee  bow. 
Each  rivals  each  with  every  kindly  art 
To  do  such  lionor  to  th}'  head  and  heart, 
As  friendly  words  and  one  brief  hour  allow. 

Thy  constant  home  is  in  the  loving  heart, 

Still  loved  the  most  by  those  who  know  thee  best. 
As  if  the  Truth  had  claimed  thee  for  her  own, 

Thy  honest  soul  disdains  each  doubtful  art. 
By  such  as  thou  the  world  is  richl_y  blest. 
For  good  men  rise  from  high  example  shown. 


THE   JUBILEE    OF    DR.    AGNEW.  313- 

There  are  who  stand  aloft  before  men's  eyes, 

Like  crnnibling  castles  better  seen  afar, 

Whose  grandeur  oft  a  nearer  view  woidd  mar,— 

Such  dire  defect  in  seeming  greatness  lies. 
The  truly  great  beget  no  sad  surpnse  : 

Humble  art  thou  and  gracious  to  thy  kind ; 

No  loud  pretense  betraj's  the  little  mind, 

No  affectation  weakness  nnderlies. 
Hippocrates  and  Galen — could  they  rise 

From  honored  tombs  and  be  with  us  to-day, 

With  kindred  souls  who  speak  the  ages  through — 
The  master-minds,  the  great,  the  good,  the  wise — 

Glad  would  they  crown  thee  with  immortal  bay, 

Beloved  by  all,  because  to  all  so  true  1 

Transcendent  master  in  thy  noble  art  1 

In  mortnl  throes  and  danger  imminent 

Thy  skilled  liand  needs  no  other  precedent. 

Who,  like  to  thee,  can  bid  the  pulses  start, 
Tears  cease  to  flow  and  wasting  fear  depart  ? 

When  Garfield  fell  and  horror  filled  the  land, 

A  nation  breathed  when  thou  didst  show  thy  hand^ 

If  not  to  heal,  at  least  to  soothe  the  smart. 
Thou,  too,  art  honored  as  a  teacher  great  I 

Benign,  as  on  a  lofty  mission  bent. 

No  secret  does  thy  candid  bosom  hold  ; 
But  free  to  all  who  on  th}^  wisdom  wait, 

A  thirst  for  knowledge  and  with  high  intent, 

Thou  dost  the  riches  of  thy  lore  unfold. 

Though  grudging  Fate  prescribe  a  narrow  bound, — 
Though  Genius  does  not  kindle  with  its  flame. 
Or  grant  to  scale  the  starry  height  of  fame 
To  all ;  yet  from  thy  higher  ground. 

How  read}'  was  tliy  big  heart  eA'^er  found, 
At  ever}'  lesser  brother's  call  in  need, 
To  give,  on  the  equal  terms,  the  kindest  heed. 
Though  to  thyself  no  vantage  should  redound  I 

No  empty  praises  do  we  sing  to  thee  : 

Could  wear}'  hospitals  thy  goodness  tell. 
Could  countless  homes  thy  benefits  unfold. 

Glad  from  the  skies  would  Love  and  Sympathy 

With  Earth's  too  sordid  children  straightway  dwell,. 
Drawn  by  the  story,  if  the  half  were  told. 


314  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

In  vain  do  these  too  hurried  numbers  tell 
The  peaceful  triumphs  of  tliy  lift}'  years 
Yain  our  applause,  vain  Friendship's  holy  tears 
That  all  unbidden  from  our  eyes  upwell — 

"While  lovinglj'  we  on  thy  virtues  dwell — 

Unless  to  us  thy  grand  achievements  give 
Some  quick'niiig  energy'-  like  thee  to  live, 
And  like  to  thee  in  living  wortli  excel. 

The  evening  shadows  lengthen  o'er  th}^  ^^y, 
Around  thee  falls  a  mild  and  mellow  light, 
Surely  from  care  thou  needest  some  release : 

Well  mayest  thou  rest  while  yet  the  lingering  ray 
Of  sunset  splendor  waits  upon  the  night, 
And  earth  and  heaven  and  thy  own  soul  sa}^  "  Peace  1  " 

The  photograph  of  each  gentleman  who  participated  in 
the  Jubilee  Dinner  of  Dr.  Agnew,  was  taken  by  the  photogra- 
pher, AV.  Curtis  Taylor,  and  mounted  in  a  specially  prepared 
album,  and  presented  to  Dr.  Agnew  as  a  souvenir  of  the 
occasion. 

This  brought  the  formal  proceedings  of  the  banquet  to  a 
close,  although  the  medical  men  lingered  long  afterward  to 
listen  to  the  informal  speeches,  and  to  shake  hands  with  Dr. 
Agnew  before  he  left  the  Academy.  At  a  meeting  of  the  com- 
mittee, held  April  23,  1888,  Drs.  S.  Weir  Mitchell,  J.  H.  Hutch- 
inson, and  S.  W.  Gross  were  appointed  the  committee  on  the 
portrait.  Bernhard  Uhle  was  selected  as  the  artist,  and  the 
splendid  picture  which  he  produced,  and  which  hangs  in  the 
College  of  Physicians,  is  regarded  by  many  as  the  first  of  his 
masterpieces.^  Dr.  S.  Weir  Mitchell  made  the  presentation 
speech,  and  the  picture  was  received  by  Dr.  W.  W.  Keen,  on 
behalf  of  the  College,  at  a  dinner  held  April  2'2,  1890.  Thus 
was  consummated  a  most  heart-felt  tribute  to  a  great  man,  be- 
loved by  his  colleagues,  and  witliout  an  enemy  in  the  profession 
which  he  had  made  his  life-work. 

On  April  19,  1890,  when  the  committee  met  to  settle  its 

'  See  Frontispiece. 


THE   JUBILEE    OF    DR.    AGNE\Y.  315 

affairs,  it  appeared  that  a  lar<^e  sur})liis  remained.  It  was 
then  resolved  that  the  balance  of  the  fund  be  expended  for  a 
portrait  of  Dr.  Alfred  Stille,  provided  that  disposition  of 
the  money  seemed  appropriate  to  Dr.  Agnew.  Such  dispo- 
sition was  sanctioned  by  Dr.  Agnew,  and  the  fine  picture 
of  Dr.  Stille  was  painted  by  the  same  artist,  Uhle,  and  hangs 
near  the  portrait  of  Dr.  Agnew  in  the  hall  of  the  College  of 
Physicians. 

On  April  24, 1888,  the  Faculty  of  Medicine  and  the  students 
of  the  Medical  Department  of  the  University  of  Pennsylvania, 
held  their  celebration  of  tlie  fiftietli  anniversary  of  the  graduation 
of  Dr.  Agnew.  On  this  occasion  the  exercises  were  held  in  the 
Chapel  of  the  University.  A  reception  consumed  the  early 
part  of  the  evening,  and  at  9  o'clock  Provost  Pepper,  of  the 
University,  made  an  introductory  speech.  Dr.  Pepper  then  in- 
troduced Professor  Samuel  W.  Gross,  of  the  Jefferson  Medical 
College,  who  made  an  address,  taking  the  career  of  Dr.  Agnew 
as  an  object  lesson.  He  concluded  by  saying :  "  In  England 
they  call  Gladstone  the  Grand  Old  Man ;  to  me,  Agnew  is  the 
Dear  Old  Man.  Long  may  he  live  to  adorn  our  profession ; 
long  may  he  live  to  shed  additional  lustre  upon  the  institution 
with  which  he  is  connected."  William  P.  Lincoln,  of  the 
Class  of  1888,  followed  with  a  speech  appropriate  to  the  occa- 
sion, and  in  behalf  of  the  undergraduates  presented  Dr.  Agnew 
with  a  gold  medal  as  a  souvenir  of  the  occasion. 

Dr.  Agnew  then  replied  to  the  remarks  which  had  been 
made.  He  pointed  out  the  fact  that  Dr.  Leidy  and  himself 
were  then  the  only  links  that  connected  the  old  University  with 
the  new.  He  then  spoke  earnestly  to  the  students,  and  in  turn 
addressed  himself  to  the  Faculty  and  Alumni,  and  urged  them 
all,  in  his  characteristic  style,  to  use  their  best  endeavors  to  fur- 
ther the  interests  of  the  University.  The  proceedings  included 
a  banquet  and  songs  by  the  University  Glee  Club.  The  com- 
mittee in  charge  of  the  banquet,  selected  J.  H.  Adams,  of  the 
Class  of  1889,  to  write  a   song  suitable    for  the  occasion,  the 


316  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

music  to  which  was  the  work  of  Hugh  A.  Clarke,  Professor 
of  Music  at  the  University.     It  was  as  follows  : — 

SONG. 

Fifty  years  of  strong  progression ! 

Half  a  century  of  rise  I 
Noblest  in  a  great  profession. 
Highest  far,  by  all  confession, 

But  gentle,  as  thy  name  implies. 

In  the  midst  of  Time's  swift  eddy, 

Fraught  with  wrecks  of  human  life ; 
Thy  figure  stands  out  strong  and  steady, 
For  thy  duty,  calm  and  ready, 
'  Never  blinded  by  the  strife. 

The  lone  cripple  in  the  alley. 

For  thy  skill,  holds  life  more  dear; 

And  thy  students,  as  they  rally. 

Bless  thee  now  from  hill  and  valley, 
Indian  jungle  and  wild  frontier. 

When  the  Leader  of  the  nation. 

Low  was  laid  by  insane  will ; 
From  the  wide-spread  consternation 
Grew  the  patient  resignation. 

Trusting  to  thy  matchless  skill. 

With  swelling  hearts,  we  meet  thee, 

Thou,  the  guider  of  our  ^a,y. 
With  loving  awe  we  treat  thee. 
With  humblest  pride  we  greet  thee, 

On  this,  thy  natal  day. 

Before  the  banquet  each  gentleman  present  was  invited  ta 
register  in  a  large  memorial  album,  which  was  presented  sub- 
sequently to  Dr.  AgneAv. 

It  was  regretted  by  many  non-professional  friends  of  Dr. 
Agnew  that  there  was  no  demonstration  paid  him  in  which 
they  could  take  part.  The  demonstration  paid  Dr.  Agnew  by 
his  fellow-physicians  was  a  most  remarkable  display  of  admira- 
tion, appreciation,  and  love  which  was  deeply  and  fully  appre- 
ciated by  him,  and  which  had  a  marked  eifect  upon  the  public, 
but  many  persons  in  other  branches  of  life  expressed  a  great 


TUE   JUBILEE    OF    DR.  AGNEW.  317 

■desire  to  join  in  some  celebration  to  his  honor.  The  possibiU- 
ties  of  the  magnitude  and  note  of  such  a  gathering  can  be  esti- 
mated when  the  interest  of  the  public,  as  manifested  in  his 
death  and  funeral,  are  considered.  This  complaint  was  ren- 
dered partly  unjust  by  the  action  of  the  Penn  Club,  which  gave 
a  reception  for  Dr.  Agnew  in  April,  1888.  By  this  means  a 
large  number  of  distinguished  Philadelphians  were  enabled  to 
meet  and  do  him  honor. 


CHAPTER  XIV. 

Dr.  .Agnew's  Retirement  from  the  University  of 
Pennsylvania. 

In  contrast  with  this  jubilee  banquet  was  the  last  didactic 
lecture  delivered  by  Dr.  Agnew  at  the  University  of  Pennsyl- 
vania, April  5,  1889.  This  lecture  was  probably  one  of  the 
pleasantest  and  yet  saddest  experiences  in  his  long-  career.  To 
understand  his  emotions  we  must  know  the  circumstances  sur- 
rounding the  occasion. 

The  jubilee  dinner  of  the  year  before  lost  much  of  its  sad- 
dening: influences  throuo-h  the  warmth  of  the  enthusiasm  and 
love  displayed,  through  the  flood  of  pleasant  memories  that 
poured  their  mellowing  influence  over  all,  like  the  beauties  of  a 
glorious  sunset ;  but,  like  the  sunset,  the  banquet  was  simply  a 
glorification  of  the  present ;  it  showed  nothing  of  the  future. 

This  last  lecture,  on  the  other  hand,  was  the  quiet,  practi- 
cal separation  of  Dr.  Agnew  from  the  most  loved  portion  of 
his  life-work.  His  chiefest  energies  had  been  expended  in 
teaching.     He  had  been  an  active  teacher  for  38  years. 

As  has  been  shown  in  the  chapter  on  Dr.  Agnew's  con- 
nection with  the  School  of  Anatomy,  he  delivered,  while  con- 
nected with  this  institution,  over  1800  lectures.  As  Demon- 
strator of  Anatomy  at  the  University  of  Pennsylvania,  a  rough 
calculation  shows  that  he  must  have  delivered  at  least  600 
lectures  while  holding  this  position.  In  his  position  as  Pro- 
fessor of  Surgery  he  must  have  delivered  at  least  2000  lectures, 
including  his  cliniques,  making  a  total,  at  the  University,  of 
about  2600  lectures. 

During  his  ten  years'  service  at  the  Philadelphia  Hospital, 
and  twelve  years  at  the  Pennsylvania,  he  delivered,  probably, 
600  more,  making  a  grand  total  of  5000  lectures.  In  the  thirty- 
eight  years  that  he  lectured,  there  were,  on  an  average,  310 
'(318) 


DR.    AGNEW'S    RETIREMENT    FROM    THE    UNIVERSITY.  319 

working-  days,  making  a  total  of  11,780  days.  Dr.  Agnew's 
vigorous  application  to  his  work  is  shown  when  it  is  seen  tliat 
he  lectured  on  5000  days,  or  nearly  every  other  day,  including 
M'inter  and  summer  vacations,  holidays,  etc.,  for  38  years.  No 
better  commentary  on  his  application  to  work  than  this  exists, 
and,  yet,  this  was  only  a  small  portion  of  his  daily  work. 

In  the  lecture,  which  is  included  in  this  biography,  there 
are,  approximately,  3000  words.  As  each  lecture  was  about 
fifty-live  minutes  long,  while  this  last  one  was  only  thirtv-five, 
it  is  but  fair  to  say  that  he  used  about  5000  words  in  a  lecture ; 
so  that,  in  his  lectures,  he  gave  enough  medical  instruction  to 
fill  a  series  of  volumes  containing  25,000,000  words,  which 
would  make  a  fair-sized  library,  filling  over  two  hundred 
volumes  the  size  of  this  biography.  The  magnitude  of  this 
service  can  be  seen  when  it  is  shown  that  these  lectures  were 
delivered  to  about  12,000  students,  who  subsequently  became 
physicians.  As  there  are  about  90,000  practising  physicians  in 
the  United  States,  the  extent  of  Dr.  Agnew's  force  as  a  factor 
in  medical  education  can  be  estimated  approximately. 

It  made  no  difterence  as  to  the  subject  of  his  lectui*e ;  his 
audience  at  once  perceived  that  he  was  not  merely  rehearsing 
to  them  a  lesson  which  he  had  himself  just  learned  for  the  occa- 
sion, but  that  he  was  laying  before  them  the  results  of  practical 
acquaintance  with  his  theme  in  all  its  bearings.  Possessing  the 
happy  faculty  of  being  able  to  tell  what  he  knew,  impressing  it 
on  the  minds  of  his  students  indelibly,  he  had  spent  the  happiest 
portion  of  his  life  in  this  work. 

He  was  now  resigning  from  his  professorial  chair  not 
because  he  felt  unequal  to  the  work  before  him,  but  because  he 
feared  that  such  a  time  might  come  upon  him  unawares.  As 
he  said  in  his  little  speech  at  the  close  of  this  lecture,  "  God  has 
given  me  the  sense — the  good  sense — to  enable  me  to  resign 
while  I  feel  that  I  am  yet  in  full  enjoyment  and  possession  of 
all  my  faculties."  He  knew  well  that  surgery  is  a  cruel  mis- 
tress; he  knew  that  when  her  servants  grow  old,  their  minds 


320  LIFE   OF    D.    HATES   AGXE^V^,    M.D.,    LL.D. 

less  active,  and  their  fingers  less  nimble,  she  holds  these  fail- 
ings up  to  the  pitiless  gaze  of  all.  She  does  not  permit  that 
greatest  gift  of  old  age, — the  power  to  rest  on  the  laurels  of  a 
life's  work,  to  maintain  the  present  by  the  memories  of  the  past. 
On  the  contrary,  she  is  as  relentless  to  the  old,  tried  follower  of 
fifty  years  as  to  the  newest  tyro  of  to-day.  This  is  one  of 
nature's  cruel  but  necessary  provisions.  Nothing  earthly  is  as 
precious  as  human  life ;  and  when  the  operator  grows  unfit  for 
his  work,  an  All-wise  Providence  proclaims  it  widely.  Dr. 
Agnew  realized  this  hard  side  of  his  profession,  and  he  stood 
more  than  ready  to  accept  its  conditions. 

His  students,  as  usual,  singularly  in  full  sympathy  with  his 
feelings,  had  decorated  the  lecture-room  with  flowers  and  plants. 
A  wreath  of  laurel  had  been  placed  on  the  central  chandelier 
so  as  to  crown,  unconsciously,  the  head  of  their  beloved 
lecturer. 

What  visions  of  the  past  and  future  must  have  swept  be- 
fore the  old  teacher's  eyes!  There  were  memories  of  the  dim 
lono-  aofo,  when  he  had  been  a  student  in  the  old  Xinth  Street 
School.  Then  there  were  the  happy  days  of  teaching  at  the 
School  of  Anatomy,  followed  by  the  long  train  of  years  at  the 
University.  These  were  all  now  ended.  He  saw  the  future 
too  clearly  to  delude  himself  with  false  hopes.  He  saw  that  he 
had  reached  the  last  great  mile-stone  in  his  career;  and  yet,  ex- 
cept for  an  occasional  hesitancy  in  manner  and  speech,  and  a 
certain  subdued  softness,  nothing  marked  his  outward  demeanor 
difierent  from  his  wont.  His  long  schooling  in  the  repression 
of  his  feelings  stood  him  in  good  stead.  This  modern  gladiator, 
who  had  fought  the  better  fight  for  health  and  happiness,  who 
had  wrung  many  victories  from  disease  and  death,  as  hard 
fought  as  that  of  Hercules  for  the  life  of  Alcestis,  must  have  felt, 
as  he  gazed  on  those  tiers  of  benches, — so  singularly  suggestive 
of  the  old  Roman  arena  and  amphitheatre, — like  the  gladiators 
of  old,  as  they  gazed  on  Ceesar  with  the  cry  on  their  lips, 
"  Those  who  are  about  to  die,  salute  you ! " 


DR.    AGNEW'S    RETIREMENT    FROM    THE    UNIVERSITY.  321 

So  much  has  been  written  of  Dr.  Agnew's  lectures  that 
this  last  lecture  is  here  incorporated.  It  was  a  short  lecture, — 
twenty  minutes  shorter  than  the  usual  lengtli.  lie  always 
spoke  extemporaneously,  without  notes  excepting  occasional 
memoranda  of  the  heads  of  the  subjects  to  be  discussed  for  the 
day.  This  lecture  was  reported  stenograpliically,  and  is  printed 
exactly  as  he  delivered  it,  without  additions.  As  he  lectured, 
he  pointed  out  the  various  anatomical  points  on  appropriate 
charts  and  performed  the  various  operations  of  tracheotomy  on 
the  body  of  a  dead  child  on  the  desk  before  him.  This  ability 
to  work  and  talk  successfully  at  the  same  time  is  a  most  diffi- 
cult task,  but,  as  has  been  said,  it  was  another  of  Dr.  Agnew's 
accomplishments. 

TRACHEOTOMY. 

Last  Didactic  Lecture  Delivered  by  Dr.  D.  Hayes  Agnew^  at  the 
University  of  Pennsylvania^  Ajml  5,  1889. 

"  Tracheotomy  is  one  of  those  operations  that  I  think  every 
medical  man  should  be  able  to  perform.  There  are  two  opera- 
tions which,  I  have  frequently  said,  every  practitioner  should 
qualify  himself  to  do,  in  consequence  of  the  danger  which 
results  from  the  loss  of  time.  One  of  these  operations  is  for 
strangulated  hernia,  and  the  other  is  tracheotomy ;  minutes 
count,  and  count  dearly,  when  any  delay  about  operations  of 
this  nature  ensues. 

"  The  subject  of  tracheotomy  is  one  that  requires,  in  the 
first  place,  a  certain  amount  of  knowledge  of  anatomy;  a 
knowledge  of  the  relation  of  the  trachea  to  the  two  sets  of  great 
blood-vessels  of  the  neck,  and  also  to  the  arteries  and  veins 
which  are  placed  immediately  in  front  of  it.  A  few  moments 
will  enable  me  to  call  your  attention  to  the  leading  anatomical 
facts  in  connection  with  this  subject.  You  will  see  upon  tlie 
blackboard  a  diagram  which  represents  the  trachea  and  the 
great  vessels  which  cross  it,  or  are  related  to  it  at  the  root  of  the 
neck,  and  also  those  which  are  placed  upon  its  side.  Here  you 
have  the  arch  of  the  aorta  giving  off",  as  the  first  blood-vessel, 


322  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

the  innominate  and  then  the  innominate  dividing  into  its  two 
principal  trunks,  the  subclavian  and  the  carotid,  and,  on  the 
opposite  side,  the  carotid  coming  off  as  a  primary  vessel  from 
the  aorta. 

"  Then,  here  is  the  trachea  disappearing,  crossed  by  this 
important  vein,  which  is  the  transverse  vein,  a  vein  which, 
when  there  is  any  difficulty  in  the  respiration,  often  becomes 
distended  to  more  than  three  times  its  normal  size,  and  there- 
fore is  within  reach  of  the  knife  when  you  are  maldng  an 
incision  into  the  trachea,  provided  that  the  knife  is  carried 
down  too  low.  Not  only  so,  but  you  notice  that  a  portion  of 
the  trachea  is  covered  up  by  the  part  of  the  innominate  artery 
which  is  a  little  to  the  right  of  the  median  line,  and,  conse- 
quently, if  your  knife  should  run  a  little  too  far  in  this  direction 
this  vessel  would  be  wounded.  By  keeping  clearly  in  your 
minds  the  relations  of  these  structures  to  the  trachea  itself  such 
errors  are  not  likely  to  occur. 

"  The  trachea  is  covered  by  skin,  superficial  fascia,  and  the 
platysma,  and,  joining  in  the  median  line,  the  sterno-hyoid  and 
the  sterno-thyroid  muscles,  with  the  deep  fascia,  and,  next  in 
order,  the  tracheal  fascia.  Crossing  the  trachea,  we  have  the 
thyroid  body,  which,  in  consequence  of  the  great  size  of  the 
middle  portion  or  isthmus,  may  sometimes  interfere  somewhat 
with  the  operation. 

"  There  are  various  operations  done  in  the  median  line  of 
the  neck,  all  of  which  can  be  explained  to  you  in  a  few  mo- 
ments if  you  will  look  at  the  skeleton  of  the  trachea  and  larynx. 

"  Always  pass  your  hand  over  the  neck  before  beginning 
your  operation,  so  as  to  make  yourself  entirely  familiar  by  touch 
with  all  the  topographical  features.  This  you  should  do  before 
dissecting  any  region,  so  as  to  notice  clearly  and  distinctly  all 
the  swells  and  depressions.  Every  part  ought  to  be  so  clearly 
recognized  that  you  could  produce  a  mental  image  of  it  at  any 
time  if  you  desired.  Pass  your  hand  down  the  median  line  of 
the  neck  and  you  feel  first  the  hard  body  of  the  hyoid  bone  and 


DR.    AGNEW'S    RETIREMENT   FROM    THE    UNIVERSITY.  323 

then  you  feel  the  most  salient  portion  of  the  neck,  the  angle  of 
the  thyroid  cartilage ;  then,  if  you  pass  a  little  further  down, 
you  come  to  another  prominence  which  is  not  so  large,  but 
which  gives  you  the  idea  of  a  dense  ring  ;  this  is  the  cricoid  carti- 
lage. Now,  if  you  let  your  finger  slip  down  in  the  median  line 
just  below  the  thyroid,  you  will  find  that  it  drops  into  a  little 
soft  space  which  separates  the  thyroid  from  tlie  cricoid, — the 
crico-thyroid  space.  Below  the  cricoid  cartilage  you  come  to 
the  receding  portion  of  the  trachea,  the  part  which  leaves  the 
surface  and  sinks  deeper  in  the  neck,  and  which  causes,  as  it 
drops  beneath  the  sternum  into  the  chest,  this  fossa  which  we 
speak  of  as  the  supra-sternal  fossa. 

"  We  come  now  to  consider  the  operations  which  may  be 
performed  to  open  the  respiratory  apparatus.  First,  there  is  the 
operation  which  consists  in  opening  the  crico-thyroid  membrane. 
This  allows  the  free  admission  of  air  to  the  tracliea,  but  it  is 
not  a  space  which  gives  any  great  room  for  removing  a  foreign 
body,  or  in  which  it  is  desirable  to  keep  a  tube  for  any  length 
of  time.  It  is  only  an  extemporaneous  operation  to  save  a 
patient  from  perishing  from  a  foreign  body  which  may  liave 
lodged  in  his  larynx,  or  when  you  have  not  the  instruments  at 
hand  to  do  a  formal  tracheotomy.  The  next  operation  is  one 
in  which  you  open  below  the  cricoid ;  this  is  tracheotomy, 
whereas,  the  one  higher  up  is  laryngotomy,  because  it  is  within 
the  limits  of  the  larynx.  These  operations  become  necessary 
from  a  great  variety  of  causes,  which  I  shall  not  stop  to-day  to 
detail,  but  I  will  pass  at  once  to  the  technique  of  the  operation 
itself 

"  What  vessels  are  there  which  must  be  kept  clearly  in 
mind  during  this  operation  ] 

"  First,  if  you  perform  the  operation  of  laryngotomy, — that 
is,  opening  through  the  crico-thyroid  space, — there  are  four  ves- 
sels, all  coming  from  the  crico-thyroid  arteries.  These  divide 
each  into  two  branches  and  send  one  small  trunk  along  the 
lower  border  of  the  thyroid  and  one  along  the  upper  border  of 


324  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

the  cricoid ;  sometimes  these  arteries  are  very  large.  Here,  on 
this  specimen,  is  one  as  large  as  the  radial  artery.  If  your  knife 
were  to  divide  that,  you  would  have  a  furious  hemorrhage,  and 
if  vou  carried  your  incision  far  enough  to  open  the  larynx  the 
blood  would  probably  enter  and  destroy  the  life  of  the  patient. 
But  rarely  is  the  artery  so  large  as  it  is  here.  Still,  when  you 
are  opening  this  space,  remember  the  existence  of  these  two 
branches  and  make  your  incision  exactly  in  the  middle,  neither 
too  near  the  cricoid  nor  too  near  the  thyroid. 

"  Then  you  have  the  other  small  branches  which  you  meet 
with  in  passing  down  the  neck,  but  which  are  practically  of  little 
import  unless  you  have  present  that  vessel  which  is  called  the 
middle  thyroid,  or  the  artery  of  Neubauer,  for  the  anatomist 
who  first  discovered  it.  It  arises  from  the  innominate,  rarely  from 
the  arch  of  the  aorta,  and  comes  directly  up  on  the  middle  of 
the  trachea.  Before  any  operation  is  performed,  always  ex- 
amine by  the  touch  to  see  if  you  can  find  any  pulsation  there. 
This  artery  is  sufficiently  common  to  make  it  possible  that  you 
may  encounter  it  in  an  operation  of  this  character. 

"  At  the  root  of  the  neck  is  a  plexus  of  veins  called  the 
thyroid  plexus.  This  preparation  enables  me  to  exhibit  to  you 
all  the  vascular  parts  that  are  of  interest  in  the  operation.  Here 
you  have  the  crico-thyroid  arising  from  the  superior  thyroid  and 
supplying  the  crico-thyroid  space.  Then  you  come  to  this, 
which  is  the  thyroid  body,  whose  isthmus  lies  directly  across  the 
trachea  covering  in  one,  two,  or  three  rings,  and  sometimes 
more  of  the  trachea  itself.  Then  from  the  bottom  you  see  this 
intricate  plexus  of  veins,  with  very  distensible  walls,  which  be- 
come very  much  distended  during  the  difficult  respiration  which 
accompanies  croup ;  so  that  often,  when  you  have  opened  the 
neck  and  have  exposed  the  tracheal  fascia,  you  will  be  almost 
deterred  from  inserting  the  knife  among  the  large  blue  veins 
which  cover  it, — if  you  are  not  familiar  with  the  operation. 
These  veins  run  down  and  empty  into  the  transverse  vein.  Next 
you  see  the  trachea  covered  in  by  the  innominate  artery,  show- 


DR.    AGNEW'S    RETIREMENT    FROM    THE    UNIVERSITY.  325 

ing^  tliat  it  is  quite  possible  to  open  it  if  tlie  knife  is  carried  too 
far.  I  saw  such  an  accident  once.  The  knife  was  carelessly 
handled  by  an  operator  while  opening  the  trachea,  and  he  cut 
but  did  not  sever  entirely  the  innominate.  The  patient  died, 
and  I  had  that  specimen  for  many  years  while  I  was  teaching 
anatomy ;  but  it  has  disappeared,  like  many  other  anatomical 
specimens,  which,  you  know,  are  difficult  to  keep. 

"  Next  you  notice  the  transverse  vein,  which  might  be 
opened,  especially  if  it  was  greatly  distended  on  account  of 
difficult  respiration. 

"  The  great  point  in  all  operations  here  is  to  keep  accu- 
rately in  the  median  line,  for  then  it  is  not  necessary  to  divide 
any  muscular  tissue  whatever.  You  have  this  linea  alba,  you 
may  say,  or  raphe  of  the  neck,  separating  all  the  muscular 
tissues.  If  you  go  to  one  side  or  the  other  and  cut  into  mus- 
cular tissue,  you  become  confounded  and  greatly  embarrassed 
in  this  simple  operation.  I  say  simple,  although  it  is  not  always 
a  simple  operation,  especially  in  that  class  of  cases  on  which 
you  will  usually  operate, — children  with  short,  fat  necks,  with  a 
movable  trachea  rising  and  falling  with  each  difficult  respiration. 

"The  administration  of  an  anesthetic  is  preparatory  to  the 
operation.  Many  cases  do  not  require  it ;  the  patient  is  in  a  semi- 
unconscious  state  and  will  make  very  little  resistance,  especially 
when  operation  has  been  postponed,  as  it  too  often  is,  to  so  late 
a  period  that  changes  have  probably  taken  place  in  the  lungs, 
making  the  operation  futile.  It  is  well  in  ordinary  cases  to  give 
the  child  a  whiff  of  chloroform  or  ether, — chloroform  often  better 
than  ether,  because  less  likely  to  excite  spasm  and  more  kindly 
received  by  the  patient, — enough,  at  least,  to  deaden  the  sensi- 
bility until  you  can  complete  that  which  is  the  sensitive  part  of 
the  operation,  namely,  dividing  the  skin  and  subcutaneous 
tissue. 

"The  instruments  required  for  that  purpose  are,  first,  a 
scalpel,  a  pair  of  forceps, — the  ordinary  instruments  that  you 
have  in  your  operating  cases, — and  a  director,  ligatures,  and 


326  LIFE   OF   D.    HATES    AGNEW,    M.D.,    LL.D. 

tenaculum ;  and  then  you  are  to  be  provided  with  such  instru- 
ments as  will  enable  you  to  keep  the  wound  in  the  trachea 
patulous.     We  have  various  instruments  for  that  purpose. 

"This  is  the  old  tracheal  tube,  as  it  is  termed.  It  is  some- 
times of  metal,  sometimes  of  hard  rubber, — the  latter  is  not  re- 
liable, as  it  is  apt  to  be  broken.  This  should  be  largely,  if  not 
entirely,  a  silver  instrument,  so  as  to  keep  it  from  tarnishing.  It 
is  simply  a  double  canula  with  two  shoulders,  so  arranged  that 
you  can  introduce  tapes  or  a  little  sticking-plaster, — preferably 
the  former, — in  order  to  hold  it  in  the  opening.  One  tube 
comes  out  of  the  other.  You  can  disarticulate  the  inner  tube 
by  turning  it  half-way  around;  the  object  of  this  is  that  the  tube 
may  be  kept  perfectly  clean.  With  a  little  screw  at  the  top  it 
is  fixed  in  place.  These  tubes  are  curved,  and  the  length  of 
them  must  depend  largely  on  the  age  of  the  patient  on  whom 
you  operate. 

"  Then  you  want  something  to  enable  you  to  guide  the 
canula  in  after  you  have  opened  the  trachea,  and,  very  fre- 
quently, this  is  a  difficult  maneuvre,  and  is  sometimes  the  most 
difficult  and  embarrassing  part  of  the  whole  operation.  Your 
tube  is  apt  to  get  to  one  side  or  the  other,  and  it  slips  in  be- 
tween the  tracheal  fascia  and  the  trachea  itself,  but,  by  introduc- 
ing something  that  will  act  as  an  obturator  and  round  off"  the 
extremity  of  the  canula,  you  can  usually  get  it  in  without  much 
difficulty ;  and  so,  in  well-appointed  operative  cases,  you  have 
this  instrument  which  acts  as  a  pilot,  and,  by  its  conical  form, 
serves  to  conduct  the  canula  into  the  opening.  You  can  get 
along  very  well, — and  economy  is  a  great  matter,  especially  with 
medical  students  and  young  practitioners, — as  a  rule,  without 
any  instruments  of  this  kind,  by  taking  a  soft  catheter  and  passing 
it  through  the  canula  till  a  small  portion  of  it  projects  at  the 
end. 

"  Then  you  require  other  instruments.  For  example  :  you 
may  need  a  little  dilator  to  expand  the  orifice  you  are  making, 
m  case  you  are  operating  for  a  foreign  body  in  the  trachea  or 


DR.    AGNEW'S    KETIKEMENT    FROM    THE    UNIVERSITY.  327 

bronchi.  That  you  could  do  with  a  pair  of  forceps ;  but,  still, 
this  is  a  useful  instrument. 

"  Then  you  require  an  instrument  to  take  out  foreign 
bodies  that  are  in  the  trachea.  You  may  introduce  this  deli- 
cate, curved  pair  of  forceps  down  till  you  reach  the  bronchial 
tube,  if  necessary,  and  take  out  a  coin,  for  instance,  which  may 
be  there. 

"Then  here  is  another  instrument  for  which  you  could 
very  well  substitute  a  feather  or  a  camel's-hair  brush.  It  is 
nothing  more  than  some  bristles  twisted  into  a  wire,  w^hich  is 
meant  to  keep  the  trachea  clear  from  the  secretions  which  accu- 
mulate and  tend  to  close  up  the  tube. 

"  Here  are  two  instruments  wdiich  will  save  you  from  what 
is  always  a  dangerous  thing  to  do,  but  which  has  been  done  as 
an  evidence  of  the  boldness  and  self-sacrifice  of  surgeons, 
namely,  applying  the  mouth  to  the  tube  and  sucking  it  clear 
wlien  the  trachea  would  otherwise  have  been  closed  from  the 
accumulations  in  it.  Here  is  a  syringe  by  which  you  can  draw 
out  the  accumulations  that  are  there,  or  by  which  you  can  keep 
up  artificial  respiration,  which  is  sometimes  necessary  from  the 
operation  having  been  delayed  so  long  that  the  patient  is  prac- 
tically moribund  when  it  is  undertaken.  By  forcing  in  air 
through  this  tube,  and  then  compressing  the  chest  again,  patients 
have  been  revived,  by  keeping  up  artificial  respiration  for  some 
time. 

"  The  retractors  are  these  two  instruments  which  you  see 
here ;  and  now  you  have  the  whole  armamentarium  which  goes 
to  make  up  a  complete  case. 

"  The  operation  is  done  as  follows :  Have  an  assistant 
to  take  charge  of  the  ether  and  give  his  w^liole  attention  to 
that.  You  may  stand  in  one  of  two  positions,  either  where  an 
etherizer  usually  stands,  at  the  head  of  the  patient,  or  you  may 
take  your  position  at  the  side  and  cut  either  from  below  upward 
or  from  above  downward.  That  is  a  matter  of  taste  altogether. 
Then,  if  you  are  going  to  open  simply  the  larynx  for  temporary 


328  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

relief,  you  palpate  and  touch  the  hyoid  bone,  the  thyroid  and 
cricoid  cartilage,  and  then  you  return  and  sink  your  finger  into 
the  crico-thyroid  space  and  immediately  drive  your  knife  ver- 
tically into  the  larynx  ;  or  you  may  pass  it  in  transversely,  which 
is  better ;  or  you  may,  if  you  please,  make  a  crucial  cut.  In 
this  way  you  may  save  your  patient's  life,  though  it  is  an  opera- 
tion of  only  temporary  value. 

"  It  is  very  easy  to  expose  the  whole  laryngeal  box  by  an 
addition  to  this  operation  Avhich  we  have  spoken  of  as  laryn- 
gotomy.  If  the  knife  is  turned  on  its  back  and  you  cut  directly 
upward  in  the  median  line,  you  separate  the  two  halves  of  the 
larynx  and  expose  it  and  make  it  easy  to  remove  a  growth  from 
the  vocal  cords  or  any  other  part  of  the  larynx.  Sometimes 
this  portion,  which  we  speak  of  as  the  angle,  is  so  thoroughly 
ossified  as  to  require  eitlier  bone-forceps  for  clipping  it,  or  the 
cartilage-knife. 

"  But  suppose  you  are  going  below  and  are  going  to  open 
the  trachea,  for  example,  for  croup.  Then  your  incision  should 
commence  at  the  bottom  of  the  thyroid  cartilage.  It  is  a  great 
convenience  to  give  yourself  ample  space,  so  far  as  the  soft  parts 
are  concerned,  and  so  begin  the  incision  that  you  will  have  a 
clear  view  of  the  median  line  and  carry  it  down  almost  to  the 
top  of  the  sternum.  The  first  incision  should  go  down  to  the 
superficial  fascia ;  then  pick  up  the  superficial  fascia,  little  by 
little,  and  divide,  and  then  the  deep  fascia  next.  When  you 
have  divided  the  deep  fascia,  you  have  exposed  at  once  the 
edges  of  the  sterno-hyoid  muscles,  and  then  your  knife  is  laid 
aside  and  you  take  your  director  and  pass  it  into  the  median 
line,  working  up  and  down  so  as  to  separate  these  muscles. 

"  You  have  divided  no  muscular  tissue  if  you  have  been 
careful  to  maintain  the  median  line. 

"  Then  you  come  to  the  connective  tissue  between  the 
sterno-thyroid  muscles.  Divide  that  and  go  down  till  you  come 
to  a  loose  fascia,  and  in  that  perhaps  you  will  see  the  veins 
bulging  up  directly  into  tlie  wound,  and  you  must  get  rid  of 
them. 


DR.    AGNEW'S    RETIREMENT   FROM    THE    UNIVERSTTY.  329 

"  Sometimes  you  can  press  tliem  off  witli  your  finger  or 
director  sufficiently  to  enable  yoii  to  get  them  out  ol"  tlie  wav  ; 
but  if  you  cannot  there  is  no  use  tying  them  individually,  but 
you  are  to  take  them  up  in  a  bunch  and  ])ut  a  ligature  of  cat- 
gut around  the  entire  mass.  Next,  breaking  up  the  tracheal 
fascia,  I  put  my  finger  in  and  feel  to  see  if  the  middle  thyroid 
artery  is  present.  If  it  is  not,  I  go  on  clearing  away  the  loose 
connective  tissue  from  the  front  of  the  trachea,  which  is  another 
very  important  part  of  the  operation,  in  order  that  the  last  steps 
of  it  may  be  successful. 

"  Many  unsuccessful  attempts  to  get  a  tube  into  the  trachea 
have  been  due  to  the  fact  that  the  trachea  has  not  been  cleaned. 
If  you  have  time,  clean  it  till  you  feel  your  director  running 
freely  over  the  cartilaginous  rings. 

"  Sometimes  you  are  embarrassed  by  the  middle  lobe  of  the 
thyroid  gland.  Sometimes  you  can  put  the  director  under  the 
whole  isthmus  and  push  it  up  toward  the  thyroid  cartilage.  If 
you  fail  to  get  rid  of  the  isthmus  in  that  way,  and  it  is  often 
very  vascular,  you  are  to  take  a  curved  needle  and  pass  it  under 
the  isthmus,  bring  the  thread  out  above,  and  allow  a  double  liga- 
ture to  remain,  tying  the  isthmus  on  either  side.  This  is  valuable 
for  another  purpose,  for  you  can  steady  the  trachea  very  much 
by  these  two  threads  ;  though  we  have  another  method  of 
doing  that.  Pass  the  director  under  the  isthmus  and  divide  it 
between  the  two  ligatures.  After  having  exposed  the  trachea, 
the  next  point  is  to  open  it.  It  is  well  enough  to  have  all 
hemorrhage  arrested,  though  there  is  a  certain  amount  of  oozing 
that  will  not  be  stopped  by  ligatures,  but  stops  the  moment  you 
put  the  tube  in. 

"  You  must  fix  the  trachea  when  you  open  it.  An  ordinary 
tenaculum  is  to  be  put  in  quickly,  because  the  trachea  is  mov- 
ing up  and  down.  It  may  be  necessary  to  have  retractors  to 
keep  the  wound  open.  Catch  the  tenaculum  in  the  cellular 
tissue  about  the  cricoid.  Keep  it  steady  for  a  moment  and  lift 
it  out  of  its  deep  sulcus.     Then  take  a  sharp-pointed  bistoury 


330  LIFE   OF   D.    HATES   AGNEW,    M.D.,    LL.D, 

and  make  your  incision  in  the  trachea  by  cutting  from  below 
upward,  for  by  so  doing  you  are  cutting  away  from  danger. 
The  knife  is  dipped  into  the  trachea,  and  the  division  of  two  or 
three  rings  exactly  in  the  middle  line  is  made. 

"  AVhen  the  incision  is  made,  the  next  thing  is  the  intro- 
duction of  the  tracheal  tube,  which  goes  through  the  wound  in 
the  neck  into  the  trachea,  and  it  may  be  secured  by  tapes  or 
adhesive  plaster,  the  tapes  being  better.  Some  put  a  suture 
directly  through  the  sides  of  the-  wound  and  through  the 
shoulders  of  the  tube.  This,  however,  is  painful  to  the  patient, 
and  is  a  practice  which  ought  not  to  be  followed. 

"  Now  comes  a  very  important  part  of  this  subject,  and  it 
is  the  after-treatment.  That  treatment  consists  in  having  a 
skilled  nurse  who  shall  be  at  the  side  of  the  bed — never  leaving 
it  for  a  moment ;  or,  if  so,  she  shall  be  replaced  by  another  of 
€qual  intelligence.  Her  duty  is,  with  a  feather  or  brush,  to 
keep  the  tube  clear  of  mucus  that  constantly  wells  up  into  it 
and  has  to  be  wiped  away.  Not  only  so,  but  the  temperature 
of  the  room  is  a  matter  of  some  importance.  It  ought  not  to 
be  below  seventy  degrees,  and  sometimes  it  is  better  to  have  it 
a  little  more.  Then  there  is  need  of  something  to  prevent  the 
intrusion  of  foreign  matter  from  the  air,  and  even  the  air  itself 
is  harmful  until  it  has  been  modified  a  little  by  passing  through 
some  medium.  We  usually  take  a  little  gauze  and  place  it 
over  the  tube,  and  we  may  moisten  it  with  a  little  boracic-acid 
solution,  so  that  the  air  is  strained  of  its  impurities  and  the 
lungs  saved  from  irritation.  Two  or  tliree  stitches  are  put  in 
to  close  up  part  of  the  external  wound  and  keep  the  tube  in 
position. 

"  The  length  of  time  the  tube  is  to  be  retained  depends 
very  much  on  the  morbid  conditions  that  have  existed  before 
the  operation.  Ordinarily  it  is  kept  in  several  days,  but  some- 
times several  weeks.  A  very  good  way  to  tell  whether  it 
should  be  taken  out  is  to  place  your  finger  over  the  end  of  it 
and  compel  the  patient  to  breathe  through  the  natural  passages; 


DR.    AGNEW'S    RETIREMENT    FROM    THE    UNIVERSITY.  331 

and  if  lie  breatlics  with  ease  for  a  considerable  period,  it  is  time 
to  remove  it. 

"  These  constitute  the  leading  points  in  connection  with 
the  operation  of  tracheotomy." 

After  this  lecture  he  addressed  the  class  as  follows : — 

"And  now,  gentlemen,  I  have  delivered  the  last  of  the  lectures 
tliat  it  h:is  been  my  privilege  and  my  pleasure  to  deliver  to  yon.  In 
taking  my  leave  from  the  associations  of  neai'l}-  my  Avhole  life-time,  I 
•cannot  do  so  without  dwelling  for  a  moment  on  the  reflections  that  this 
■occasion  gives  rise  to.  I  have  been  connected  with  this  Institution  since 
its  earliest  days,  through  its  rapid  growth  to  wliere  it  stands  to-day,  in 
the  front  rank  of  the  medical  institutions  of  the  country'.  With  a  feel- 
ing of  satisfaction  that  I  can  thus  behold  this  Institution  which  we  love 
so  dearly,  I  turn  to  contemplate  the  retirement  which  I  have  sought. 

"There  comes  a  time  in  the  life  of  everj'  man  when  he  wants  to  be 
free,  when  he  feels  that  even  the  pleasant  duties  and  congenial  tasks 
"which  have  been  his  lot  grow  heavy, — I  have  reached  that  time.  I  feel 
like  the  galley-slave,  who,  with  manacles  thrown  off,  breathes  the  air  of 
freedom.  For  over  fort}"  j'ears  I  have  been,  as  thej^  say  in  theatrical 
parlance,  on  the  boards  before  the  public,  and.  as  I  glance  backward  over 
that  long  period  of  almost  a  life-time,  three  most  delightful  thoughts 
■come  to  me.  Tlie  first  of  these  is,  that  at  no  time  have  I  ever  been  re- 
ceived b}^  any  act  of  discourtesy  or  nnkindness  b}'  an}-  of  the  gentlemen 
wliom  I  have  had  the  honor  to  address  here  (prolonged  applause).  The 
second  is,  that  the  post  of  responsibility  which  it  has  been  my  cherished 
privilege  to  hold  here  was  one  that  I  had  never  sought.  It  came  to  me 
unbidden.  And  the  third  thought  is,  that  God  has  given  me  tlie  sense — the 
good  sense — to  enable  me  to  resign  it  while  I  feel  that  I  am  yet  in  the 
full  enjoyment  and  possession  of  all  my  faculties.  These  I  have  en- 
deavored to  strengthen,  to  broaden,  and  to  render  useful  in  the  sphere 
of  my  professional  life,  for  I  feel  that  I  have  lived  to  very  little  account 
if  I  have  not  lived  to  learn. 

"In  a  few  days  we  part,  some  of  us,  perhaps,  to  meet  no  more. 
How  eagerly  and  deeply  would  I  impress  on  you  your  duties  as  ph}'- 
sicians.  You  have  chosen  a  profession  wliich  is  one  of  the  highest  and 
noblest  that  a  man  can  make  his  calling.  See  that,  by  your  faithful  zeal 
and  application,  you  endeavor  to  maintain  it  in  all  the  dignity  that 
belongs  to  it. 

"  As  we  take  this  leave,  I  wish  that  nil  of  you  may  prosper;  that  it 
may  be  your  aim  to  elevate  j'our  lives  and  to  round  them  off  in  the  full- 


332  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

ness  of  an  undeviating  regard  for  dut}'  and  high  purpose;  that,  in  short, 
3'ou  may  be  good  men  and  true,  good  physicians,  and  pure,  good,  and 
honorable  citizens.  I  trust,  in  the  ettbrt  to  attain  these  high  marks  in 
the  life  that  stretches  out  before  3'ou,  that  you  may  continue  in  a  rever- 
ent regard  for  the  faith  that  has  sustained  you,  guarded  yon  from  the 
paths  of  evil.     I  can  say  no  more.     God  be  with  you." 

No  one  realizes,  until  he  attempts  it,  how  difficult  it  is  to 
talk  to  medical  students  in  the  strain  as  that  shown  by  Dr. 
Agnew  in  this  little  speech.  He  knew,  of  course,  that  the  class 
represented  the  most  diverse  religious  beliefs.  There  were  all 
kinds  and  divisions  of  Christians,  as  well  as  Agnostics,  Israelites, 
Persians,  Mohammedans,  Japanese,  etc.  To  be  personal  and 
appealing  without  wounding  their  religious  feelings  is  a  very 
tactful  and  difficult  task. 

A  few  days  later,  at  the  One  Hundred  and  Fifteenth  An- 
nual Commencement  of  the  Department  of  Medicine  of  the 
University  of  Pennsylvania,  held  May  1,  1889,  at  the  Academy 
of  Music,  a  painting  of  Dr.  Agnew  was  presented  to  the  Uni- 
versity by  the  three  undergraduate  classes  of  the  Medical  De- 
partment. It  has  been  the  custom  from  time  immemorial  to 
present  the  portrait  of  a  professor  retiring  from  his  department, 
to  hang;  in  the  hall  of  the  Wistar  and  Horner  Museum.  This 
collection  has  grown  to  be  the  most  valued  possession  of  the 
Medical  School,  as  was  shown  at  the  fire  in  May  1888,  when 
the  students,  at  the  risk  of  their  own  lives,  saved  these  paint- 
ings, although  warned  by  the  firemen  not  to  attempt  such  fool- 
hardy risks. 

The  invitation-cards  engraved  for  this  commencement  had 
in  the  corner  a  representation  of  the  head  of  Dr.  Agnew,  in  honor 
of  the  occasion.  Dr.  Joseph  Allison  Scott,  of  the  graduating 
class,  in  a  few  appropriate  words  made  the  presentation.  "This 
is  our  Agnew  Day,"  he  said,  "and  well  may  we  be  impressed  by 
its  solemnity,  for  it  is  the  last  time  that  we  shall  see  our  be- 
loved professor  before  us  in  his  official  capacity." 

Then    the   veil,   whicli    had    concealed    the    portrait,   Avas 


u 


DR.    AGNEW'S    KETIRExMENT    FROM    THE    UNIVERSITY.  333 

slipped  off,  showing  a  life-size  likeness  of  Dr.  Agnew  standing 
in  the  clinical  amphitheatre,  having  just  completed  an  opera- 
tion,— removal  of  a  cancer  of  tlie  hreast.  All  the  figures  in  the 
group  were  taken  from  life.  His  assistants  are  dressing  the 
wound,  while  Dr.  Agnew  has  stepped  to  the  rail  of  the  clinique- 
seats  and  is  explaining  what  he  has  done,  and  its  rationale} 

The  painting  is  seven  by  eleven  feet  without  the  frame,  and 
is  regarded  as  one  of  the  masterpieces  of  that  famous  artist,  who 
has  made  a  specialty  of  medical  subjects,  Thomas  Eakens. 

The  treatment  of  the  subject  is  an  amplification  of  the 
portrait  of  Dr.  Gross  done  by  the  same  artist.  The  picture 
incidentally  shows  an  interesting  change  in  surgery,  the  wliite 
garments  of  Dr.  Agnew  and  his  assistants  being  an  inno\ation 
due  to  antiseptic  surgery,  unknown  in  Dr.  Gross'  time. 

This  picture  has  been  criticised,  not  for  the  ability  of  the 
artist,  or  for  the  artistic  merit  of  his  work,  for  the  portrait  of 
Dr.  Agnew  is  as  life-like  as  is  possible  and  the  delineation  of 
the  clinique-room  is  perfect,  but  for  the  idea  embodied, — that  of 
presenting  Dr.  Agnew  in  the  act  of  operating.  While  a  sur- 
gical operation  is  rarely  pleasant  to  a  layman,  and,  consequently, 
sucli  a  subject  must  be  more  or  less  repulsive  to  the  general 
public,  yet  at  the  same  time  it  was  this  work  wdiich  made  Dr. 
Agnew  famous.  This  picture,  intended  to  be  hung  in  the 
Medical  School,  is  certainly  not  unworthy,  as  it  represents  the 
most  important  side  of  Dr.  Agnew's  life-work  ;  for  its  resting 
place  it  is  perfectly  proper. 

While  engaged  in  painting  this  picture,  the  artist  dis- 
covered forcibly  one  of  Dr.  Agnew's  peculiarities.  Dr.  Agnew 
had  been  represented  with  blood  attached  here  and  there  to  his 
hands  ;  noticing  this  point,  at  once  he  objected  most  strenuously, 
and,  despite  the  artist's  protests  for  fidelity  to  nature,  he  ordered 
all  the  blood  to  be  removed. 

1  The  following  is  tlie  inscription  on  the  frame  of  the  painting  :  "  D.  Hayes  Agnew, 
M.D.  Chirnrgus  expertissiinus  ;  scriptor  et  doctoi-  clarissimus  ;  vir  veneratus  et  carissiinus." 
which,  being  translated,  reads  :  "  The  most  experienced  surgeon,  the  clearest  writer  and 
teacher,  the  man  most  beloved  and  venerated." 


334  LIFE    OF   D.    HATES   AGNEW,    M.D.,    LL.D. 

The  criticism  is  made  that  surgeons  grow  hriital,  but  here 
was  a  surgeon,  who  had  been  accustomed  to  working  in  blood 
for  fifty  years,  who  had  not  had  his  sense  of  propriety  blunted 
in  the  least. 

The  portrait  was  received  on  behalf  of  the  trustees  by  Dr. 
S.  Weir  Mitchell,  Chairman  of  the  Medical  Committee  of  the 
Trustees.  In  a  brief  speech  he  accepted  it  in  his  usually  happy 
style,  concluding :  "  Whenever  you  become  involved  in  doubt 
and  uncertainty,  think  what  Dr.  Agnew  would  have  done,  and 
YOU  will  be  sure  to  have  done  the  rio-ht  thins:." 

When  Dr.  Mitchell  sat  down,  there  was  a  loud  cry  of 
"  Agnew  "  from  all  parts  of  the  house.  In  response  to  the  cally 
Dr.  Agnew  rose  slowly  and  stepped  to  the  foot-lights.  This- 
was  the  signal  for  a  universal  burst  of  applause  and  a  deafen- 
in.":  clapping  of  hands.  When  the  noise  had  subsided,  Dr. 
Agnew  turned  smilingly  to  liis  counterpart  in  oil  and  said  that 
though  he  had  often  heard  of  "  speaking  likenesses,"  this  did  not 
hold  in  the  present  instance,  however  excellent  the  representa- 
tion, for  he  would  be  compelled  to  do  the  speaking  himself. 
Continuing,  he  said  :  "  Perhaps  you  have  not  all  heard  the  story 
of  the  old  woman  who  had  spent  her  life  toiling  in  a  kitchen  in 
London.  Finally,  being  placed  in  a  position  to  follow  out  her 
inclinations,  she  determined  to  free  herself  from  all  the  trouble 
and  turmoil  of  this  life,  and  accordingly  she  built  for  herself  a 
mansion  outside  of  the  city,  fitted  out  with  every  modern  luxury. 
But  every  once  in  a  while  she  became  tired  of  her  com- 
forts and  an  ungovernable  longing  came  over  her,  and  she 
would  come  back  occasionally  to  London  to  her  old  kitchen,  te 
'  smell  its  grease.'  So,  now  that  I  have  retired  into  compara- 
tive ease,  if  life  should  become  unbearable  to  me,  I  shall  still 
retain  the  consolation  of  going  across  the  river  occasionally  te 
hear  the  boys'  yell." 

At  this,  Dr.  Agnew  '■  heard  the  boys'  jell "  where  he 
stood,  and  such  was  the  din  that  he  was  unable  to  proceed  for 
several  minutes.     When  the  house  had  quieted  down  finally. 


DR.    AGNEW'S    RETIREMENT    FROM    THE    UNIVERSITY.  335 

he  addressed  a  few  words  of  earnest  advice  and  exliortation  to 
them,  and  lie  was  just  turning  to  his  seat  when  lie  staogored. 
A  thrill  of  horror  ran  through  the  house,  but  he  caught  him- 
self almost  immediately,  and  before  Provost  Pepper,  with  his 
usual  tact,  could  go  on  with  the  program,  to  conceal  the  occur- 
rence, he  recovered  his  equilibrium  and,  turning  again  to  the 
students,  said,  in  a  firm,  distinct  voice,  "  I  wish  you  all  success 
in  your  profession."  He  did  this  to  assure  them  that  nothing 
serious  had  happened. 

He  had  been  suffering  all  the  mormng  ii'om  a  very  acute 
attack  of  indigestion,  which  brought  on  a  considerable  amount 
of  dizziness.  This,  with  the  glare  and  heat  of  the  foot-lights 
over  which  he  was  standing,  the  moving  sea  of  upturned  faces, 
and,  possibly,  with  some  natural  emotion  under  the  circum- 
stances, caused  this  momentary  indisposition.  It  gave  the  stu- 
dents a  chance  to  study  that  imperturbability  of  manner  under 
the  most  startling  circumstances  which  Professor  William  Osier, 
in  the  valedictory  address  a  few  minutes  before,  had  declared  so 
necessary  in  the  young  physician. 

Dr.  Agnew,  by  his  resignation  from  the  teaching  force  of 
the-  University,  sought  more  time  for  leisure.  It  was  his  inten- 
tion to  devote  less  time  to  work  and  more  to  recreation.  As  he 
said  in  his  speech,  he  had  reached  the  time  when  he  wished  to 
be  free  from  the  exacting  duties  of  his  life,  and,  moreover,  his 
experience  as  a  physician  had  taught  him  that  he  had  reached 
that  time  of  life  when  he  must  naturally  expect  to  lessen  his 
output.  His  life  became  more  social,  he  began  to  spend  more 
time  with  his  family,  and  his  home-life,  which  had  been  scriously 
interfered  with  throughout  his  whole  life,  was  now  fuller  and 
more  satisfactory.  Dr.  and  Mrs.  Agnew  were  able,  at  length, 
to  devote  considerable  time  to  each  other. 

■  Thus  quietly  and  unostentatiously  Dr.  Agnew 's  life  sped 
on,  broken  only  by  such  occasional  incidents  as  those  just 
related.  He  sought  rest  more  and  more  from  his  labors, 
although  his  nature  and  obliging  disposition  led  him  to  work 


336  LIFE    OF    D.    HAYES    AGXEVT,    M.D.,    LL.D. 

far  more  than  he  intended,  and  far  more  than  he  should  have 
done.  He  found  it  impossible  to  shake  off  a  large  part  of  his 
work.  He  was  still  wanted  at  operations,  and  even  if  he  would 
not  operate  many  physicians  wanted  him  present,  simply  to  give 
his  opinion  and  sanction  as  to  the  course  pursued. 

Dr.  Agnew's  reputation,  at  this  period,  had  grown  so  great 
that  it  was  no  longer  an  honor  for  him  to  be  associated  with  an 
institution,  but,  on  the  contrary,  an  honor  to  the  institution. 
By  this  time  he  had  been  made  considting  or  honorary  surgeon 
to  nearly  all  the  hospitals  and  dispensaries  in  town,  such  as  the 
Gynecean  Hospital,  the  Kensington  Hospital  for  AVomen,  the 
Philadelphia  Dispensary,  etc. 

In  these  later  years  Dr.  A^-new  took  more  interest  in 
politics.  He  had  been  a  life-long  Democrat,  although  never 
active  in  political  work.  The  rejuvenation  of  the  Democratic 
Party  by  President  Cleveland  aroused  his  flagging  interests,  and 
he  eao:erlv  watched  and  commended  the  beliefs  and  actions  of 
this  Democratic  Moses. 

A  representati\"e  from  the  University  of  Pennsylvania,  who 
visited,  in  the  course  of  his  duties,  a  large  proportion  of  the 
universities  of  Europe,  had  the  curiosity  to  inquire  of  the  difl'er- 
ent  officials,  professors,  and  students  what  men  at  the  University 
of  Pennsylvania  they  were  femiliar  with.  He  found,  of  course, 
that  in  their  own  lines  of  work  the  different  European  scientists 
were  acquainted  with  the  men  doing  that  line  of  work  at  the 
University,  but  he  found  that  there  were  but  two  men  ^^■ho 
were  universallv  known,  and  their  career  and  deeds  recosfuized 
and  appreciated.  These  were  Leidy  and  Agnew.  Knowing  that 
so  much  of  Dr.  Leidy's  work  was  of  such  a  kind  that  it  would 
be  distributed  throughout  the  educated  world,  it  was  not  a  sur- 
prise to  find  his  name  so  familiarly  quoted,  but,  as  Dr.  Agnew 
worl^ed  in  a  field  and  in  a  way  wliicli  was  naturally  fjir  more 
local,  his  constant  recognition  was  rather  surprising. 

Undoubtedly,  if  Dr.  Agnew  had  gone  abroad  in  the  last 
few  years  of  his  life  he  would  have  received  many  honorary 
degrees  from  European  universities,  as  did  Dr.  Gross. 


DR.    AGNEW'S    RETIREMENT    FROM    THE    UNIVERSITY.  337 

The  degrees  whicli  lie  received  were  few  in  number:  as 
lias  been  said,  in  1861  he  received  from  Princeton  College  the 
honorary  degree  of  A.M.,  which  was  followed,  in  1874,  by  the 
conferring  of  the  degree  of  Doctor  of  Laws  by  the  same  insti- 
tution. On  June  6,  1888,  the  University  of  Pennsylvania  con- 
ferred on  him  the  degree  of  LL.D. 

Dr.  Agnew's  last  appearance  at  a  public  meeting  of  any 
sort  was  at  the  Musical  Fund  Hall,  February  27,  1892,  on  whicli 
occasion  he  responded  to  a  toast  on  the  professors  of  his 
youth,  at  the  first  triennial  banquet  of  the  combined  Alumni 
of  the  University  of  Pennsylvania.  He  found,  when  he  began  to 
speak,  that  his  voice,  which  was  usually  so  distinct,  would  not 
respond  to  the  demand  made  upon  it,  and,  although  the  hall  has 
excellent  acoustic  properties,  it  was  only  by  the  strictest  silence 
that  his  remarks  could  be  heard.  He  spoke  on  a  favorite  topic, — 
the  outlining  of  the  characters  and  careers  of  his  early  teachers. 
In  such  delineation  as  this  he  was  peculiarly  happy.  Like  the 
artist  who,  with  a  few  quick,  bold  strokes  of  his  pencil,  gives 
the  outline  of  a  figure,  in  which  what  is  left  out  is  suggested, 
so  Dr.  Agnew,  in  a  half-dozen  terse  phrases,  could  etch  the 
personality  of  one  of  these  former  giants.  He  felt  very  much 
dissatisfied,  after  his  speech,  with  what  he  had  said,  although  to 
his  auditors  it  was  an  unusually  interesting  and  absorbing  nar- 
ration. He  was  compelled,  on  account  of  feeling  ill,  to  hurry 
home  that  night,  directly  after  the  delivery  of  his  speech. 

Judge  M.  Russell  Tliayer,  who  also  replied  to  a  toast  at 
this  same  banquet,  brought  out  a  curious  and  beautiful  coin- 
cidence in  his  own  career,  which  applied  unconsciously,  but 
equally  well,  to  Dr.  Agnew.  The  substance  of  what  he  said  is 
as  follows :  "  Fifty  years  ago  I  graduated  from  the  University 
of  Pennsylvania.  The  Commencement  exercises  were  held  in 
this  hall.  During  this  long  period  of  time  the  course  of  events 
has  carried  the  University  far  to  our  westward,  and  for  many  years 
this  old  historic  building  stood  alone  and  deserted  in  this  rather 
disreputable  portion  of  the  city.     Now  that  the  western  por- 


338  LIFE    OF    D.    HAYES    AGNET7,    M.D.,    LL.D. 

tion  of  the  city  has  been  built  up,  attention  has  been  turned 
bacii  again  to  this  old  site,  and  it  has  been  rejuvenated,  and 
our  alumni  banquet  is  held  within  its  walls,  and  here  I  am 
speaking  again  in  the  hall  which  I  left  as  a  graduate  fifty  years 
ago.  It  seems  as  if  the  cycle  of  my  life  has  been  made  complete 
and  I  have  returned  to  the  spot  from  whence  I  started,  after  a 
life's  journey." 


CHAPTER  XV. 

Dr.  Agnew's  Final  Sickness,  Death,  and  Funeral. 

Dr.  Agnew's  death  came  as  he  desired  it, — a  quick  tran- 
sition from  a  busy  hfe  to  an  eternal  reward.  lie  found  in  later 
years  tliat,  after  undue  exertion  on  his  part,  he  was  subject  to 
slight  attacks  of  angina  pectoris,  due,  as  was  afterward  proven, 
to  the  ossification  of  the  coronary  arteries.  He  had,  in  the 
winter  of  1889-90,  a  severe  attack  of  epidemic  influenza,  from 
which  he  never  fully  recovered.  Following  this,  he  had  an 
attack  of  broncho-vesicular  catarrh,  of  moderate  severity.  On 
several  occasions  he  had  passed  renal  calculi,  and  there  had 
been  slight  manifestations  both  of  diabetic  and  albuminuric 
conditions.  On  Wednesday,  the  9th  of  March,  1892,  after 
operating,  he  returned  home  at  3  o'clock,  when,  remembering 
that  he  had  forgotten  to  see  a  case,  he  went  out. 

During  this  last  operation,  which  he  performed  on  this 
day,  it  was  necessary  to  give  him  brandy  a  number  of  times, 
although  the  operation  lasted  but  half  an  hour.  Immediately 
after  the  operation,  before  he  left  the  house  of  the  patient,  the 
attack  became  so  severe  that  he  became  firmly  possessed  of  the 
belief  that  he  was  going  to  die  then  and  there. 

On  his  return  home  the  second  time,  he  was  seized  again 
with  anginose  symptoms,  and  was  compelled  to  remain  in  his 
office  for  a  number  of  hours  before  he  could  be  removed  to  his 
bedroom.  For  the  next  two  or  three  days  he  improved  to  such 
a  degree  that  he  saw  several  of  liis  friends.  In  the  evening  of 
Saturday,  March  12th,  he  became  much  worse.  His  condition 
from  this  time  until  the  day  of  his  death  was  simply  a  fluctua- 
tion from  slight  hope  to  positive  liopelessness.  During  tliis 
time  he  was  thoroughly  conscious  of  his  physical  condition,  and 
controlled  largely  the  treatment  of  his  case.  On  Sunday,  INIarcli 
20th,  he  fell  into  a  comatose  condition,  in  which  he  remained 

(389) 


340  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

until  the  moment  of  his  death,  which  was  at  twenty  minutes  of 
three  on  the  afternoon  of  March  22,  1892.  The  immediate 
cause  of  his  death  was  uremia,  due  to  the  failure  of  the 
kidneys  to  perform  their  usual  functions. 

An  autopsy  was  held  on  March  23,  1892,  at  which  time 
there  were  revealed  the  conditions  which  had  been  diagnosed 
before  death.  He  had  met  with  a  severe  fall  a  couple  of  years 
before  his  death,  and  the  members  of  his  family  were  anxious 
to  determine  whether  the  injury  at  the  base  of  his  skull  could 
be  in  any  way  connected  with  the  diabetes  which  subsequently 
appeared.  There  was  the  trace  of  nothing  abnormal  in  his 
brain  ;  it  was  rather  small  in  size,  but  the  convolutions  were 
most  tremendously  marked  and  totally  dissimilar  in  each 
hemisphere. 

The  American  Anthropometric  Society  desired  to  secure 
his  brain,  that  it  might  be  placed  in  their  collection  alongside 
of  tliat  of  Dr.  Leidy.  The  object  of  this  society  is  to  place  the 
study  of  the  human  brain  upon  a  satisfactory  scientific  basis. 
Cerebral  topography  is  in  many  respects  incomplete ;  brains  of 
low,  if  not  degenerate,  type  have  furnished,  for  the  most  part, 
the  results  which  have  thus  far  been  obtained.  It  is  evident 
that  this  is  not  desirable.  Knowledge  should  be  drawn  from 
sources  which  indicate,  so  far  as  it  is  possible  so  to  do,  the 
peculiarities  of  brain-structure  of  all  classes  of  society.  While 
it  is  comparatively  easy  to  secure  the  brains  of  criminals  and 
those  who  have  been  inmates  of  city  hospitals,  it  is  quite  diffi- 
cult to  obtain  brains  of  a  higher  expression  of  cerebral  structure, 
and  to  study  such  with  the  aid  of  complete  histories.  To  meet 
and  overcome  these  difficulties,  the  society  has  appealed  to  the 
educated  classes  for  assistance.  They  request  the  members  of 
the  higher  classes  of  America  to  bequeath  their  brains  to  the 
use  of  the  society. 

As  Dr.  Agnew  had  not  joined  the  society,  although  he  was 
cognizant  of  its  existence,  Mrs.  Agnew  did  not  feel  that  it  was 
his  wish  to  have  his  brain  added  to  this  collection ;  and  as  she  felt, 


DR.    AGNEW'S    SICKNESS,    DEATH,    AND    FUNERAL.  341 

personally,  a  great  repugnance  to  such  an  idea,  she  did  not  con- 
sent to  their  request. 

On  March  2-ltli  a  plaster-cast  was  taken  of  Dr.  Agnew's 
head,  face,  and  hands  by  Mr.  Thomas  Eakens,  the  artist,  and 
Mr.  Samuel  M.  Murray,  the  sculptor.  On  the  evening  of  March 
23d  the  Philadelpliia  County  Medical  Society  held  a  large  meet- 
ing, at  which  appropriate  resolutions  in  regard  to  his  death  were 
passed.  The  following  evening  the  College  of  Physicians  called 
a  meeting  for  a  similar  purpose. 

On  Friday,  March  25th,  Dr.  Agnew  was  buried.  At  half- 
past  1  P.M.  private  services  were  held  at  his  residence,  1601 
Walnut  Street,  by  the  Kev.  W.  Hamilton  Miller,  D.D.,  pastor 
of  the  Bryn  Mawr  Presbyterian  Clunx-h,  which  Dr.  Agnew 
attended  in  the  summer  months.  The  funeral  cortege  then 
moved  out  Walnut  Street  to  Twenty-first  Street,  where  the 
funeral  services  were  to  be  conducted  in  the  Second  Presby- 
terian Church.  Eight  members  of  the  Agnew  Surgical  Society 
bore  the  body  to  the  hearse.  Probably  never  has  there  been 
a  more  impressive  and  solemn  procession  on  Walnut  Street  than 
this  one.  As  the  long,  stately  line  moved  along  in  the  bright 
sunshine  of  a  glorious  spring  day,  it  seemed  as  though  Nature 
were  rejoicing  to  receive  into  her  embrace  all  that  was  mortal 
of  him. 

"  Not  since  the  burial  of  Lincoln  has  there  been  in  this 
city  such  a  demonstration  of  distinguished  homage  as  W'as  man- 
ifest at  the  funeral  of  Dr.  David  Hayes  Agnew.  The  great 
church  was  crowded  to  its  outer  doors  with  a  patient  congrega- 
tion, glad  even  to  be  near  a  service  in  which  they  could  not  all 
participate  by  reason  of  their  multitude.  Hundreds  tried  in 
vain  to  join  those  who  filled  all  the  available  space  within,  and 
many  lingered  near  at  hand  on  the  sidewalk  to  the  close  of  the 
services.  Of  those  who  filled  the  body  of  the  church,  repre- 
senting all  classes  of  society,  the  majority  were  men  of  all 
the  learned  professions  beside  those  of  medicine  and  surgery. 
In  weight  of  character,  in   wealth   of  learning,  in   dignity  of 


342  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

exalted  position,  a  nobler  or  more  notable  array  of  the  living 
never  joined  in  such  a  tribute  to  the  honored  dead." 

No  mere  professional  and  scientific  eminence  would  have 
drawn  out  such  a  tribute.  Behind  the  physician,  behind  the 
man  of  talent,  learning,  and  skill  tliere  was  a  personal  character 
which  gave  all  these  a  value  higher  than  their  own.  His  pro- 
fessional fidelity  and  success  were  such  as  to  command  tlie 
respect  and  admiration  of  his  associates  and  the  love  and  confi- 
dence of  the  subjects  of  his  skill.  He  had  the  incommunicable 
2-raciousness  of  one  who  humblv  recoo-nized  and  leaned  on  a 
higher  than  human  power  in  all  he  learned  and  achieved.  He 
wielded  to  the  full  an  influence  wliicli  mere  ability  and  skill 
will  never  possess.  By  professional  brethren  and  pupils,  no  less 
than  by  unlearned  and  trustful  patients  innumerable,  he  w^as 
consulted,  cherished,  revered  in  a  Avay  possible  only  toward  one 
who  is  at  once  a  Christian  and  a  physician. 

Such  a  man  deserves  to  be  set  before  the  community,  and 
especially  before  the  rising  generation  of  medical  students  and 
practitioners,  as  an  ideal  and  an  inspiration.  Unhappily,  there 
is  often  a  divorce  between  the  dual  ministrations  of  soul  and 
body,  although  God  has  wedded  them  in  a  union  sacred  and 
lasting  as  life.  Jesus  Christ  was  himself  a  physician  alike  to 
the  physical  and  psychical  diseases  of  men.  He  was  the  divine 
healer  alike  of  the  sick  and  the  sinful.  And  while,  in  the 
economy  of  grace,  there  is  properly  a  difi'erence  of  function 
between  the  medical  doctor"  and  the  Gospel  minister,  they  rep- 
resent the  two  sides  of  one  and  the  same  work.  The  physician 
who  is  wise  enough  not  to  ignore  the  pharmacy  of  grace,  and 
the  minister  wdio  is  wise  enough  not  to  ignore  the  potency  of 
medicine,  in  so  far  fulfills  the  ideal  of  his  vocation.  Occasionally 
the  two  are  combined  in  one,  as  in  the  case  of  St.  Luke,  "  the 
beloved  physician."  They  are  divinely  fulfilled  in  one  glorious 
ideal  in  the  person  of  "  the  Son  of  Man." 

The  large  congregation  mourning  the  death  of  Dr.  Agnew 
were  but  the  inner  group  of  a  vast  multitude  scattered  every- 


DR.    AGNEW'S    SICKNESS,    DEATH,    AND    FUNERAL.  343 

where  throughout  the  land,  wlio,  in  tlicir  indebtedness  to  tlie 
great  physician  ibr  tliemselvcs  or  their  loved  ones,  mourn  tliat 
they  shall  see  his  lace  no  more.  And  whether  they  consciously 
recognize  the  secret  of  it  or  not,  there  can  be  no  question  that 
they  largely  owe  their  debt  of  gratitude  to  the  personal  virtue 
going  out  of  liim  as  a  Christian  physician.  Others  of  the 
great  throng,  sincerely  mourning  his  loss,  will  chcrisli  liim  as 
an  illustrious  instance  of'  one  who  combined  the  most  eminent 
scientific  ability  and  culture  with  unfaltering  faith  in  revealed 
religion  and  in  Jesus  Christ  as  the  Divine  Healer  of  all  tlie  ills 
of  man. 

Clustering  in  chairs  on  the  centre  of  the  platform  were  the 
Rev.  Moses  D.  Hoge,  of  Richmond,  Virginia,  a  life-long  friend 
of  the  dead  master;  the  Rev.  J.  Addison  Henry,  D.D.,  Mod- 
erator of  the  Presbytery  of  Philadelphia  ;  the  Rev.  C.  A.  Dickey, 
D.D.,  representing  the  Presbyterian  Hosj)ital;  the  Rev.  George 
Dana  Boardman,  D.D.,  as  Chaplain  of  the  University  of  Penn- 
sylvania ;  and  Dr.  John  S.  Macintosh,  Dr.  Agnew's  pastor. 

When  Dr.  Macintosh  entered  the  pulpit,  he  uttered  a  brief 
prayer,  and  tlien  announced  the  hymn  beginning, 

"  Come  unto  me  when  shadows  darkly  gather  ; 
When  the  sad  heart  is  weary  and  distressed," 

and  added  that  all  the  hymns  to  be  sung  during  the  service 
were  very  dear  to  Dr.  Agnew. 

Prayer  was  then  offered  by  the  Rev.  J.  Addison  Henry,  in 
which  he  feelingly  spoke  of  the  death  of  the  eminent  surgeon, 
saying:  "AVe  thank  Tliee  for  this  beautiful  life  taken  from  us, — 
so  faithful,  so  true,  so  loving,  so  wise.  He  cared  for  us  in  our 
sickness ;  watched  most  tenderly  over  our  loved  ones  who  have 
passed  away.  So  true  to  t]i€  interests  confided  to  him,  we  re- 
joice that  he  was  so  faithful  to  Thee.  He  loved  the  Master  and 
served  Him  most  faithfully  all  the  days  of  his  life,  and  he  loved 
the  Church  of  the  living  God.  Thou  hast  taken  liim  to  Thyself; 
to  the  society  of  those  who  loved  and  feared  Thee  when  on  earth." 


344  LIFE    OF    D.    HATES    AGNEW,    M.D.,    LL.D. 

The  Old  Testament  Scripture  lesson  was  read  by  the  Rev. 
George  Dana  Boardman,  and,  by  request,  he  selected  the  39th 
and  23d  Psalms,  the  former  begmnmg  :  "I  said  I  will  take  heed 
unto  my  ways." 

Then  in  sweet,  low  tones  was  sung  the  familiar  hymn, 
"  Nearer  my  God,  to  Thee,"  This  was  followed  by  the  reading 
of  the  Epistle  of  the  Resurrection  by  the  Rev,  C,  A.  Dickey, 
who,  by  special  request,  selected  the  Scripture  commencing: 
"  If  the  dead  rise  not,  then  is  not  Christ  risen." 

Following  the  Scripture  lesson,  Dr.  Macintosh  delivered  an 
address,  founded  on  the  31st  verse  of  the  16th  chapter  of 
Proverbs :  "  The  hoary  head  is  a  crown  of  glory  when  found  in 
the  way  of  righteousness."     He  said: — 

"  Crowned  with  glory  is  his  hoary  head  !  Yes,  that  hoary 
head  we  all  knew  so  well  and  loved  so  deeply  through  these 
many  years  is  crowned  to-day  ;  crowned  with  the  mournful 
respect  of  this  sore-stricken  community  and  this  saddened  land; 
crowned  with  the  tearful  love  of  countless  bereaved  friends, 
many  of  them  the  best  and  foremost  of  our  time ;  crowned  by 
the  sincere  affection,  love,  and  high-heaped  honors  of  the  noble 
and  ennobling  profession  wherein  he  stood  foremost  and  was 
greeted  as  a  father ;  crowned  by  his  church  and  the  broad 
Christian  brotherhood  that  knew  his  earnest,  simple  piety,  his 
sincere  convictions,  and  his  life-long  manifestation  of  Christ-like 
virtues ;  crowned  by  us  all,  and  right  worthily,  for  this  man  of 
science  and  of  skill  was  a  man  of  goodness  and  of  God ;  and 
he,  if  ever  another,  was  always  found  in  the  way  of  righteous- 
ness. So,  'tis  fitting  that  we  should  think  of  him  who  was  to 
us  so  helpful  and  inspiring. 

"  Another  friend  has  gone  !  Ah  !  how  true  he  was  to  all 
he  loved !  Another  helper  passed  away  from  struggling  hu- 
manity !  Ah !  how  ready  he  was  with  words  of  cheer  and 
works  of  mercy  !  Another  master  foremost  in  wisdom  silent 
forever  !  Ah  !  how  fondly  loved  for  his  own  unique  worth  and 
his   stored  wisdom   that  we  may  use  no   more !     And  another 


DR.    AGNEW'S    SICKNESS,    DEATH,    AND    FUNERAL.  345- 

member  gone  out  of  this  flock  of  Christ  tliat  needed  him  so 
much ;  but  gone  from  us  to  the  light  and  peace  of  the  eternal 
fold,  the  welcome  reward  of  his  Father  and  his  God. 

"  He  was  one  over  whom  we  may  well  lift  our  praises,  both 
for  his  own  sake  and  still  more  in  honor  of  Him  who,  as  our 
friend  himself  was  ever  first  to  say,  had  made  him  all  he  was. 
For  this  beloved  physician  ever  stood  forth  the  conscious  steward 
of  the  good  gii'ts  of  God,  humbly  owning  the  Hand  that  had 
guided  him,  lovingly  tracing  the  wisdom  so  manifest  through- 
out his  life,  and  daily  recognizing  his  supreme  obligation  to  liis 
Eternal  Judge. 

"  He  teas  a  gift,  a  glory,  and  a  benediction. 

'■'■He  loas  a  gift !  Yes;  a  right  royal  gift  he  was  from  the 
Giver  of  every  good  and  perfect  gift.  There  is  the  gift  of  healing. 
Let  us  recognize  it,  and  let  us  own  Him  out  of  whose  hands  we 
get  it  for  our  health  and  our  comfort !  If  with  clear  eye  we  behold 
in  the  Aholiabs  and  the  Bezaleels  of  the  plastic  fingers  and  the 
witty  inventiveness  ;  if  we  find  in  the  statesmanship  and  leader- 
ship of  a  Moses  and  a  Joshua ;  if  we  greet  in  the  righteousness 
of  a  Samuel  and  the  poesy  of  a  David ;  if  we  own  in  the  far- 
sighted  philosophy  of  a  Paul,  or  the  high-soaring  genius  of  an 
Isaiah  or  a  John,  a  gift  from  God  to  man,  shall  we  not  as  truly,. 
as  wisely,  and  as  reverently  find  a  heavenly  gift  in  a  Luke,  who,  as 
'  beloved  physician,'  comes  with  healing  powers  to  stricken,  suffer- 
ing humanity,  to  troubled  households,  to  great,  useful  lives  that 
need  to  be  kept  alive  and  made  whole  for  the  communities  in 
which  they  are  strengths  and  lights  and  joys,  and  so  reveals 
himself  to  us  as  a  very  gift  from  on  liigh  ]  Right  worthily  does 
the  Great  Apostle  class  with  the  'Word  of  wisdom'  and  the 
'  Word  of  knowledge '  the  '  Gift  of  healing,'  and  recognizes  in  it 
the  hand  of  the  administrative  and  enriching  Spirit  of  God. 
And  such  a  gift  we  had  in  this  student  of  tireless  patience,  who 
started  with  no  special  advantages  of  position  ;  in  this  strong- 
soul  of  thoughtful  resolution,  who  honestly  willed  that  nothing 
to   be  learned  in   his  profession  or  in  the  gathering  lights  of 


346  LITE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

advancing  science  which  might  minister  nnto  human  help  should 
be  for  liim  unknown ;  in  this  keen-eyed  investigator,  who  was 
as  busy,  as  eager  and  hungry  for  the  last  facts  of  real  knowledge 
in  his  riper  years  as  he  was  in  the  days  of  adventurous  youth; 
in  this  ever-growmg  man  of  power,  so  quietly  won  and  hon- 
estly deserved  and  sweetly  used ;  in  this  modest  spirit,  so  firm, 
so  gentle,  who  by  his  rare  capacity  for  tireless  application,  by 
his  life-long,  yet  intensifying  devotion  to  a  beloved  and  entranc- 
ing calling,  by  his  pure  and  rniselfish  surrender  to  the  exacting 
demands  of  an  enormous  practice,  and  by  his  embracing  all  the 
large  possibilities  of  his  lofty  professional  chair,  has  risen,  without 
stirring  jealousy  or  envy  amid  the  plaudits  of  his  brethren,  and 
the  glad  heart  of  the  community  in  which  he  was  a  member,  to 
be  a  master  in  medicine  and  our  chief  in  surgery ;  in  him  shall 
we  not  own  a  gift — yes,  here,  and  in  this  hour  recognize  a  gift 
loaned  for  a  while  and  now^  recalled  1  And  in  doing  so  we  only 
take  what  I  can  here,  as  his  pastor  and  his  closest  friend,  all 
solemnly  affirm  to  have  been  his  own  view  of  himself  and  his 
work.  For,  he  owned  himself  a  steward  of  the  good  gifts  of 
God ;  acknowledged  himself  the  servant  of  all,  bound  to  go 
about  continually  doing  what  good  he  might,  and  openly  con- 
fessed and  worshipped  and  lifted  up  before  him  as  his  model 
that  one  Divine  Master,  the  Great  Physician,  who  Himself  went 
about  continually  doing  good. 

"  Well  do  I  remember  how,  on  one  occasion,  as  I  was 
speaking  of  the  relation  of  Jesus  Christ  to  the  medical  profession, 
and  calling  Him  the  ideal  for  all  to  whom  the  work  of  healing 
w'as  committed  as  a  life-task,  the  strong  face  of  my  friend  flushed 
and  his  eyes  brightened  and  the  lofty  form  grew  more  erect ! 
And  the  next  morning  brought  me,  as  was  not  unusual,  the 
loving  note  of  thankfulness  that  told  me  how  the  man's  heart 
had  ansW'Ored  to  the  preacher's  words.  No  wonder  the  commu- 
nity to-day  feels  poor  and  we  stand  bereaved. 

"iJe  ^vas  a  gl^orij  !  Agneio,  of  Philadelphia!  That  was  his 
name.  The  name  and  the  man  were  an  honor  and  an  ornament 
to  our  city  and  to  our  University. 


DR.    AGNEW  S    SICKNESS,    DEATH,    AND    FUNERAL.  347 

"  Well  do  I  recall  the  days  abroad,  when  in  Edhibnrgh 
and  Glasgow,  and  in  Belfast  and  Dnblin,  in  Paris,  in  Berlin  and 
Vienna,  my  Philadelphia  heart  has  bounded  within  me  and 
swelled  with  generous  pride  as  the  great  surgeons  of  tljose  great 
scliools  would  name  him  with  praise,  and  tell  of  liis  achieve- 
ments and  repeat  some  of  his  words  of  wisdom.  To-day,  how- 
ever, is  not  the  season,  for  long  time  must  not  be  taken,  to 
speak  at  length  of  what  a  glory,  and  dignity,  and  attraction,  and 
inspiration  he  was  to  those  ardent  youths,  to  those  tlironged  and 
eager  classes  that,  year  after  year,  crowded  tlie  old  room,  ever 
so  dear  to  himself,  back  of  St.  Stephen's,  and  to  those  who,  in 
later  days,  from  packed  University  benches,  watched  the  marvel- 
ously  swift  sweep  of  those  unique  hands  right  and  left, — each 
firm,  both  sure  and  quick, — ^and  listened  almost  breathlessly  to 
the  unrivaled  clearness  and  briefness,  but  comprehensiveness,  of 
his  own  luminous  discourse,  and  gave  him  not  infrequently  tlie 
outbursting  cheer  that  made  even  the  old  man  once  more  a  bov, 
and  bound  '  the  boys,'  as  he  loved  to  call  tliem,  closer  to  him- 
self and  made  them  love  him  as  a  father ;  and  not  a  few  of  tliem 
weep  over  him,  as  I  myself  have  seen,  with  a  grief  that  unfitted 
some  of  them — not  the  weakest  of  men — for  immediate  duty, 
and  made  them  seek  tlieir  offices  for  thouglit,  if  not  for  prayer. 

Himself  and  his  University  are  indissolubly  wedded.  She, 
the  great  and  growing  University,  gave  to  him  the  splendid 
arena  where,  before  the  New  World  and  some  representatives 
of  the  Old,  he  proved  his  acknowledged  greatness  as  an  oper- 
ative surgeon ;  she  placed  him,  year  after  year,  in  tliose  fresli 
circles  of  young,  eager  life,  wliich,  in  his  clinics,  freshened  and 
inspired  him;  she  joyously  yielded  to  him  homage,  generous 
praise,  and  largest  encouragement ;  she  opened  to  him  a  clear 
path  to  his  own  primacy,  and  welcomed  ever  his  counsels  for  her 
wise  changes  and  continuous  enlargement.  And  he,  on  his 
side,  lent  to  her  mucli  of  liis  own  calm  and  elevated  dignity, 
graced  her  with  a  large  mc^asure  of  his  own  honor,  summoned 
hundreds  to  her  halls  year  by  year,  made  her  light  more  brilliant, 


348  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

and  threw  about  her  much  of  his  own  rich  and  pure  renown. 
The  city  and  college  were  proud  to  call  him  '  ours,'  and  each 
was  better,  stronger,  nobler,  and  more  widely  known  because  he 
was  one  of  ourselves  and  in  our  midst, — '  a  glory  and  a  safe- 
guard ! '     -Yes ;  he  was  a  glory. 

^'■And  he  was  a  benediction.  There  are  men  who,  by  their 
very  presence,  confer  a  benefit  upon  all  who  know  them.  He 
was  of  such  a  very  foremost  chief.  There  are  men  who  can  see 
moral  greatness  ;  there  are  men  who  can  picture  greatness  ;  but 
there  are  men  themselves  so  great  they  think  not  of  it,  yet  ever 
stamp  on  all  they  meet  some  of  their  own  overflowing  greatness^ 
and  make  moral  strength  beautiful  to  all  who  touch  them.  Of 
such,  he  was  one.  There  are  men  who  are  bettered  by  a  noble 
profession  ;  there  are  a  few  men  who  better  even  the  two  noblest 
callings  on  this  side  of  the  grave,  and  among  the  latter  he  whom 
we  have  lost  stood  very  high-raised  indeed. 

"  Now,  such  a  surgeon  and  physician  as  was  Dr.  Agnew, — 
joining  a  whole-souled  self-surrender  to  his  profession  with  a 
wholly  unselfish  fulfillment  of  its  exacting  and  lofty  duties;  join- 
ing a  majestic  calmness  of  judgment  with  piercing  and  instanta- 
neous insight ;  joining  the  sympathetic  tenderness  of  a  fatherly 
heart  to  the  singular  coolness  of  the  most  perfect  self-control; 
joining  the  daring  courage  of  a  fearless  operator  to  tlie  soberest 
caution  of  supremely-felt  responsibility;  joining  the  broad,  com- 
prehensive wisdom  and  knowledge  of  a  great  physician  to  the 
skill  and  power  of  the  master-surgeon,  and  lifting  all  this  splendid 
and  singular  combination  up  into  the  unity  of  his  own  dignified, 
modest,  gentle,  and  responsive  personality, — such  a  man  is  a  rare 
benediction.  Benediction, — yes ;  one  of  the  rarest,  if  he  stand 
in  his  ever-widening  circle  of  influence,  ready  to  pour  out  the 
treasures  of  his  skill,  to  devote  the  forces  of  his  soul  to  all  who 
may  be  helped,  to  use  the  powers  of  liis  hand  and  the  wealth  of 
his  genius  and  character  upon  his  younger  brethren  of  his  own 
profession  and  upon  any  sick  and  wounded  ones  who,  on  the 
Jericho  road  of  our  common  distress,  appeal  to  him  for  succor 


Dr.  Agnew  in  1890. 


DR.    AGNEW'S    SICKNI']SS,    DEATH,    AND    FUNERAL.  349 

and  sympathy.  All  this,  yea,  more,  do  we  all  know  that  he 
was,  and  for  long  years  proved  himself  to  be. 

"  Ah,  what  a  gap  he  leaves  !  As  great  as  he  was  good,  and 
better,  even,  than  great !  But  we  ye.t  stand  too  close  to  take 
aright  his  measure,  and  so  learn  our  loss.  Yes ;  he  was  a  gift, 
a  glory,  and  a  benediction. 

"  Brethren  of  this  glorious  profession,  still  so  dear  to  me 
because  of  many  a  precious  memory  ;  young  men,  candidates  for 
fellowship  in  this  goodly  guild ;  Christian  men  and  women 
gathered  in  this  silent  sorrow,  what  calls  to  holy  living  are 
sounding  in  our  ears !  What  thrilling  inspirations  come  in  this 
sad  hour  of  parting  !  What  a  cloud  of  witnesses  from  the  spirit- 
world  group  themselves  in  cheering  circles  round  us !  Rise  to 
these  stirring  summonses ;  answer  nobly  to  these  voices ;  throw 
your  heroic  manhood  into  the  good  fight ;  make  your  woman- 
hood loveher  by  sweeter  services  and  more  Christly  charities. 
Let  us  not  forget  that  out  of  this  pew  passed  the  pure-souled 
Lenox  Hodge,  and  out  of  tliat  has  just  gone  the  princely 
Agnow  ;  and  moved  by  their  bright  examples,  and  moulded  into 
saintly  symmetry  by  the  same  Spirit's  hand,  and  mastered  by 
the  same  Lord  and  His  love,  let  us  as  heavenly  children  work 
the  will  of  our  Heavenly  Father  while  it  is  called  to-day." 

The  Bev.  Moses  D.  Hoge,  D.D.,  of  Bichmond,  Va.,  an 
old-time  friend  of  the  lamented  surgeon,  who  had  been  very 
dear  to  him  all  his  long  life,  closed  the  services  with  an  address 
and  with  a  benediction. 

"As  the  years  wear  on,"  he  said,  "all  true  ministers  of 
Christ  are  conscious  of  an  ever-increasing  desire  to  comfort  those 
who  need  consolation.  The  Pastor  has  to  bear  the  sorrows  of 
a  great  multitude.  Every  time  a  member  of  his  flock  is 
afflicted  his  heart  is  smitten,  and  there  are  times  when  he  feels 
how  inefficient  all  his  efforts  are  to  console  those  wdio  need  con- 
solation. But  sympathy  will  not  accomplish  everything.  What 
could  we  do,  my  dear  ministerial  brethren,  were  it  not  our  priv- 
ilege, when  we  go  to  homes  made  dark  and  desolate,  to  say : — 


350  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

"  '  Come,  ye  disconsolate,  where'er  ye  Ifingnish, 
Come  to  the  mercy  seat,  ferventl}^  kneel  ; 
Here  bring  your  wounded  hearts  ;  here  tell  your  anguish ; 
Earth  has  no  sorrow  that  Heaven  cannot  heal.' 

"  AVhen  I  look  over  this  vast  assemblage,  hushed  and  stilly 
and  see  the  tears  not  only  of  bereaved  relatives,  but  of  a 
bereaved  community,  I  cannot  but  feel  that  we  all  constitute 
one  sorrowing  brotherhood  and  need  consolation.  Not  only  in 
this  city,  but  in  how  many  homes  in  this  great  land,  from  the 
North  to  the  South  and  from  the  East  to  the  West,  are  there 
those  who  to-day  stand  before  God  smitten  and  afflicted !  I 
know  it  is  true  in  the  home  I  have  left  to  come  and  pay  this 
loving  tribute  to  one  who  was  dearer  to  my  heart  than  any  man 
north  of  the  Potomac. 

"  But  I  come  here  not  to  speak  of  the  good  citizen,  nor  of  the 
successful  teacher,  or  the  eminent  author ;  not  even  of  the  man, 
endeared  as  he  was  to  us  by  his  many  attractive  virtues. 

"  I  come  to  speak  of  the  humble  Christian,  the  servant  of 
God,  and  for  His  sake  the  servant  of  the  church  he  loved  so 
well;  and  to  the  Pastor,  who  to-day  mourns  a  loss  which  even 
his  words  cannot  give  us  an  adequate  conception  of.  I  come 
to  speak  of  one  who  was  an  honest  servant  of  the  Church  and 
of  the  community  whose  throes  he  felt  so.  keenly,  and  to  which 
he  ministered  with  a  tenderness  of  his  own. 

"  I  come  to  magnify  not  the  man,  but  the  grace  of  God  that 
most  ennobled  his  life,  and  that  made  so  tranquil  and  peaceful 
his  death. 

"  Physical  strength  may  be  entwined  with  the  most  charm- 
ing grace  of  character,  but  the  time  will  when  even  that 
strength  will  fail.  The  only  staff  is  the  one  the  preacher 
alluded  to  in  the  Twenty-third  Psalm,  that  of  the  Good  Shep- 
herd, Honor  and  power  give  no  joy  to  tlie  heart  that  lies  still 
in  the  coffin,  and  all  the  music  of  the  world's  applause  fails  to 
penetrate  the  dull,  cold  ear  of  death. 

"  As  I  look  over  this  audience  and  see  in  it  such  a  large 


DR.    AGNEW'S    SICKNESS,    DEATH,    AND    FUNERAL.  351 

proportion  of  young-  men  who  have  in  view  one  of  the  noblest 
callings  of  life,  I  am  reminded  of  the  propriety  of  saying  a 
word  in  regard  to  the  bearing  of  science  and  Christianity.  I 
know  very  well  that  the  heart  of  our  friend  was  often  troubled 
at  the  skepticism  which  prevailed  among  scientific  men,  and  I 
stand  here  on  this  occasion  to  bear  testimony  to  the  ftict  that» 
the  more  he  investigated  the  ideas  and  teachings  of  the  scien- 
tific studies  to  which  he  gave  his  life,  the  firmer  became  his 
confidence  in  religion.  In  one  of  the  last  letters  he  wrote  to 
me  he  said :  '  Christ  to  me  is  all,  and  my  aspiration  is  for  the 
immortality  to  come.'  His  testimony  is  something  worth  treas- 
uring in  your  memories. 

"  His  was  a  complete  life.  Do  you  know  of  anything  in 
which  it  was  incomplete '?  There  are  very  few  complete,  sym- 
metrical, well-rounded  lives. 

"  How  often  it  happens  that  the  historian  does  not  live  to 
complete  his  final  volume,  or  the  sculptor  his  final  work  of  art ! 
Not  so  Avith  this  complete  life — an  honored  life,  a  peaceful  end, 
and  heaven  to  crown  it  all. 

"  And  now  we  are  to  follow  him  to  the  tomb  and  lay  him 
there,  in  the  sure  and  blessed  hope  of  a  certain  resurrection ; 
and  in  the  midst  of  our  grief  let  us  be  grateful  that  the  ties  of 
friendship,  when  sealed  by  the  blood  of  Jesus,  are  ties  which 
nothing  can  finally  sever.  For  these  associations  shall  have  a 
resurrection  beyond  the  grave.  It  is  but  a  little  time,  and  we 
look  forward  to  the  season  of  union  and  recognition  in  the 
everlasting  glory.  In  the  midst  of  our  grief  we  can  say :  '  Glory 
to  the  Father,  and  to  tlie  Son,  and  to  the  Holy  Ghost,  as  it  was 
in  the  beginning,  is  now,  and  ever  shall  be,  world  without  end. 
Amen.' " 

Under  Dr.  Macintosh's  instructions  the  great  throng  which 
crowded  the  aisles  and  the  seats  slowly  passed  the  casket,  and 
many  were  there  who  sobbed  as  they  looked  their  last  upon 
him  they  knew  well  and  loved. 

Memorial  sermons  were  preached  on  Dr.  Agnew  by  several 


^52  LIFE    OF   D.    HATES    AGNEW,    M.D.,    LL.D„ 

ministers.  Dr.  Macintosh,  on  Sunday,  April  3,  1892,  delivered 
a  memorial  address,  taking  as  his  subject,  "  The  Beloved  Phy- 
sician," his  text  being  Colossians,  iv,  14.  The  Rev.  Thomas  A. 
Hoyt,  D.D.,  pastor  of  the  Chambers  Presbyterian  Church, 
preached,  on  the  same  day,  from  the  same  text.  On  Sunday, 
March  27th,  Rev.  W.  C.  Rommel,  at  the  Gaston  Presbyterian 
Church,  preached  a  sermon  on  Dr.  Agnew,  taking  as  his  sub- 
ject, "  The  Blessed  Physician."  On  this  same  date.  Rev.  T. 
De  Witt  Talmage,  of  Brooklyn,  also  delivered  a  sermon,  taking 
Dr.  Agnew  and  his  life  as  his  subject. 

There  were  innumerable  other  sermons  preached  which  con- 
tained more  or  less  reference  to  Dr.  Agnew  and  his  career.  On 
April  13,  1892,  Dr.  De  Forest  Willard  read  before  the  Phila- 
delphia County  Medical  Society,  by  invitation,  a  paper  on  Dr. 
Agnew's  life  and  surgical  work. 

The  newspaper  notices  on  Dr.  Agnew's  death  were  tre- 
mendous. Out  of  the  eighty  thousand  periodicals  in  this 
country,  over  nine-tenths  contained  considerable  accounts  of  his 
life  and  work.  It  was  surprising  to  note  the  familiarity  of  each 
journal  with  his  name  and  life-work. 

After  Dr.  Agnew's  death  there  were  a  number  of  sugges- 
tions made  that  a  suitable  permanent  memorial  should  be  made 
in  his  name.  Certain  of  his  admirers  went  so  far  as  to  offer, 
through  the  columns  of  the  Public  Ledger^  large  sums  of 
money  if  some  one  would  take  hold  of  this  movement.  A 
number  of  letters  received  from  different  portions  of  the  coun- 
try also  gave  voice  to  the  same  sentiment.  As  yet  this  move- 
ment has  not  taken  shape,  but  undoubtedly,  if  it  were  pushed 
properly,  a  suitable  memorial  could  be  made  for  him. 

A  mausoleum  has  been  erected  in  the  beautiful  cemetery 
of  West  Laurel  Hill,  sacred  to  Dr.  Agnew's  memory,  and  here, 
near  the  country  home  he  had  loved  so  well,  his  ashes  will  rest 
in  peace. 


CHAPTER  XVI. 

Estimate  of  Dr.  Agnew's  Position  in  Surgery. 

Dr.  Agnew  was  undoubtedly  fortunate  in  the  time  of  his 
birth.  It  occurred  just  as  modern  medicine  was  beginning  to 
grow;  during  his  hfe-time  medicine  developed  into  a  great 
science,  and  his  death  did  not  come  until  surgery — his  principal 
life-work — stood  on  a  well-nigh  perfect  foundation. 

This  century,  which  has  seen  so  many  other  professions 
and  industries  spring,  Minerva-like,  into  full-grown  existence, 
has  been  as  fully  acquainted  with  wonderful  strides  in  medi- 
cine. It  is  no  exaggeration  to  say  that  medical  study  has 
made  a  greater  adv^ance  in  the  past  ninety  years  than  it  did  in 
the  entire  previous  history  of  the  world. 

There  was  a  culmination  of  conditions  which  brousfht 
about  this  wonderful  change.  The  phenomena  of  disease  are 
so  varied  and  require  such  a  tremendous  range  of  observation 
over  such  long  periods  of  time,  that  no  one  man,  or  even  set 
of  men,  could  arrange  them  on  a  scientific  basis.  It  required 
the  simultaneous  and  continued  action,  for  a  long  series  of  years, 
of  a  large  body  of  scientific  observers,  working  under  tlie  most 
favorable  circumstances,  to  bring  medicine  anywhere  near  the 
condition  of  a  science.  Taking  up  the  application  of  remedies 
for  the  cure  of  disease,  the  discovery  of  the  proper  drugs  was  a 
slow,  uncertain,  and  discouraging  work ;  for,  even  when  appar- 
ently powerful  remedies  were  discovered,  the  proper  means  to 
determine  the  efficiency  of  these  agencies  were  unknown. 

The  crude  manner  in  which  this  investigation  was  car- 
ried on,  as  a  brilliant  therapeutist  has  said,  was  somewhat  as 
follows : .  When  Adam  was  sick,  Eve — for  undoubtedly  the  first 
physician  was  a  woman — administered  to  him  some  preparation 
made  from  an  herb,  plant,  or  shrub.  If  Adam  recovered  from 
his  illness,  the  data  were  jotted  down  in  the  old  lady's  memory, 

''  (353) 


354  LIFE    OF    D.    HATES    AGNE^F,    M.D.,    LL.D. 

— for  she  must  have  been  old  by  this  time, — and  when  Adam 
was  sick  again  and  presented  the  same  symptoms  she  gave  the 
same  remedy.  The  fact  that  Adam  recovered  was  sufficient 
proof  to  her  of  the  efficacy  of  her  treatment.  The  suggestion 
that  he  might  have  recovered  from  his  illness  despite  her  medi- 
cine, or  that  her  drugs  had  had  no  effect  upon  him  either  way, 
never  entered  into  her  decision  of  the  case.  Seeing  the  disease, 
giving  the  remedy,  and  getting  the  relief  was  the  natural  method 
of  primitive  therapeutists.  Thus  there  grew  up  in  every  com- 
munity a  system  of  empiricism  or  treatment  based  upon  experi- 
ence, which,  as  seen  to-day,  could  easily  be  wholly  and  radically 
wrong. 

Not  only  was  the  work,  even  wlien  done  in  a  natural  and 
practical  manner,  misleading,  but  there  were  also  a  number  of 
factors  which  retarded  medical  progress  terribly.  One  of  these 
was  the  attitude  held  by  the  olden  masters  of  medicine,  who 
constantly  looked  for  curious  solutions  to  medical  truths.  For 
the  human  mind,  ever  eager  to  find  great  governing  laws  of 
nature  to  control  the  phenomena  of  disease,  was  not  content 
with  these  slow,  uncertain  processes  of  discovery.  Hence  be- 
gan that  fruitless  search  for  some  hidden  law  which  should 
govern  the  application  of  drugs  in  disease.  For  example,  there 
sprang  up  in  the  Middle  Ages  the  doctrine  of  the  "Law  of 
Signatures,"  which  taught  that  a  drug  should  be  given  which 
resembled  in  appearance  the  organ  which  was  supposed  to  be 
diseased.  For  example :  in  liver  diseases  there  should  be  given 
aloes,  from  its  fancied  resemblance  to  this  organ.  Tlirough  co- 
incidence aloes  did  do  good  occasionally,  by  its  purgative  action; 
hence,  on  such  deceptive  data  as  this,  the  therapeutists  of  the 
Middle  Ages  felt  that  they  had  established  a  great  law  in  medi- 
cine. In  a  similar  manner  there  arose  other  absurdities,  such  as 
Perkin's  Tractors,  the  law  of  "  Similia  Similibus  Curantur,"  etc. 

The  result  of  these  curious  delusions  was  that  clear-headed 
observers  became  dis"-usted  with  the  efforts  which  thev  were 
making  for  the  cure  of  disease,  and  so  the  natural  reaction  to 


ESTIMATE    OF    DR.    AGNEW's    POSITION"    IN    SURGERY.  355 

this  misleading-  tendency  came  at  last ;  it  was  seen  to  its  fullest 
extent  in  the  Viennese  school.  Tlie  masters  of  this  great  centre 
of  medical  education  swung  to  the  other  extreme  of  the  pendu- 
lum, and  became  therapeutic  nihilists,  believing  that  medicines 
were  of  no  avail  whatever  in  disease. 

This  unconsciously  gave  the  great  opportunity  which  was 
to  advance  medicine,  for  under  the  sway  of  these  teachers  the 
natural  history  of  disease,  uninfluenced  by  the  effects  of  medi- 
cine, was  studied  for  the  first  time.  The  pure  phenomena  of 
diseased  conditions  were  seen  and  described  at  last,  as  a  basis 
for  all  future  medical  study  and  comparison. 

The  real  condition  of  affairs  in  medical  circles  two  centuries 
ago  was  seen  by  many  clear-headed  observers.  For  example : 
when  Boerhaave,  the  great  Ley  den  physician,  died,  he  left  a 
handsomely  embellished  volume,  m  which  he  said  would  be  found 
all  of  the  real  medical  literature  of  the  world  and  all  of  the 
valuable  precepts  of  medical  teaching.  When  the  book  was 
opened  it  was  discovered  that  it  consisted  almost  entirely  of 
blank  pages.  Only  one  page  contained  any  statement;  on 
this  it  was  written,  "  Keep  your  feet  warm,  your  head  cool,  and 
your  bowels  open."  Thus  did  the  great  Dutch  physician 
aptly  express  the  real  extent  of  medical  teaching  at  that 
period.  It  is  true  that  a  great  many  facts  and  a  great  many 
disconnected  points  relating  to  medicine  were  already  known, 
but  they  projected  here  and  there,  like  disconnected  mountain- 
peaks,  and  there  had  been  thrown  between  them  no  connect- 
ing links  of  joining  knowledge.  They  were  useless  to  the 
profession. 

Here  and  there  a  far-sighted  practitioner,  living  in  advance 
of  his  age,  such  as  Benjamin  Bush  or  John  Hunter,  saw  far 
enough  into  Nature's  truth  to  prescribe  courses  of  treatment 
which,  even  to-day,  must  be  regarded  as  quite  scientific  and 
proper ;  but  at  the  beginning  of  the  century  the  great  cloud  of 
superstitious  knowledge  still  hung  over  the  mass  of  the  medical 
profession  of  the  world. 


356  LIFE    OF   D.    HATES    AGXEW,    M.D.,    LL.D. 

Thus  it  was  that  at  the  beginning  of  the  nineteenth  century 
lio'ht  was  beoinnins:  to  break  on  medical  fields.  Medical  men 
were  slowly  emerging  out  of  the  mists  and  uncertainties  of  this 
strange  search  for  specifics  in  disease.  They  were  just  beginning 
to  learn  that  the  way  to  acquire  Nature's  truths  is  to  study 
Nature's  phenomena.  It  seems  a  curious  thing  that  it  required 
so  many  hundreds  of  years  to  reach  this  apparently  obvious  and 
natural  method  of  studying  disease.  Pathology  was  beginning 
to  be  comprehended ;  obstetrics  was  being  elevated  into  the 
dignity  of  a  distinct  branch  of  medical  study ;  gynecology  was 
discovered ;  while  surgery  was  making  a  few  bold,  incisive  in- 
trusions into  a  largely  unknown  region,  and  therapeutics,  the 
basis  of  all  medical  work,  was  beginning  to  grow  into  an  accu- 
rate science  through  the  medium  of  experimental  study  upon 
animals.  In  all  this  advancing  work  the  American  physicians 
were  eagerly  pushing  to  the  front,  although  they  were  terribly 
handicapped  by  the  fact  that  the  majority  of  their  number  were 
dependent  for  their  livelihood  upon  their  practice,  and  hence 
could  not  spare  the  time  for  original  work  or  laboratory  investi- 
gations. 

It  was  at  this  time  that  Dr.  Agnew  was  born.  There  was 
growth  in  every  direction  at  this  period  throughout  the  civilized 
world.  America  was  rapidly  spreading  out  her  domains  farther 
and  fartlier  in  every  direction.  The  growth  of  railroads,  the 
introduction  of  the  use  of  steam,  the  use  of  electricity,  the 
extension  of  the  use  of  the  printing-press,  and  all  the  varied 
factors  which  make  up  modern  life  were  just  budding  into 
active  existence. 

The  same  conditions  Avhich  caused  Dr.  Agnew  to  fail  as  a 
business  man  were  to  extend  a  thousand-fold  his  opportunities 
as  a  physician. 

The  medical  journals  of  the  day  were  becoming  important ; 
their  pages  were  filled  with  the  new  successful  work  which  was 
being  poured  forth  by  many  encouraged  workers.  Dr.  Agnew 
grew  up  with  this  inspiring  condition  of  affairs  surrounding  him. 


ESTIMATE    OF    DR.    AGNEW'S    POSTTIOX    IN    SURGERY.  357 

Following  his  graduation  came  the  most  wonderful  discovery,  as 
far  as  he  was  concerned,  that  ever  occurred  in  medicine.  It 
shaped  his  future  career  after  he  felt  tliat  he  liad  decided  it  for 
himself.  This  was  the  practical  application  of  the  use  of  chloro- 
form and  ether  in  surgery.  The  power  of  these  drugs  to  pro- 
duce a  condition  of  unconsciousness  had  long  been  known ,^  but 
whether  they  could  be  safely  used  had  not  been  determined. 
This  does  not  detract  from  the  fame  of  the  bold  men  whose 
names  are  associated  with  their  introduction,  These  operators, 
unenlightened  by  any  precedent,  who  pushed  the  appHcation  of 
these  drugs  on  their  patients  until  they  sank  into  that  profound 
stage  of  unconsciousness  which  is  necessary  for  surgical  work, 
were  as  bold  as  Columbus  when  he  dared  to  push  his  vessel's 
prow  persistently  to  the  westward  in  search  of  the  Indies. 

To  us  of  the  present  day,  who  are  so  familiar  with  anes- 
thesia and  anesthetics,  it  is  scarcely  possible  to  estimate  tlie  im- 
portance of  these  discoveries  in  the  field  of  surgical  activity. 
On  them  is  dependent  the  present  condition  of  surgery.  The 
existence  of  the  pains  of  consciousness  prevented  the  great  ma- 
jority of  the  major  operations  in  surgery,  while  those  that  were 
done  were  performed  only  through  the  greatest  courage  on 
the  part  of  the  operator  and  patient.  Time  was  so  valuable,  on 
account  of  the  intense  agony  of  the  patient,  that  only  a  few 
hurried  cuts  could  be  made  in  the  course  of  an  operation  ;  in 
consequence,  no  careful  work  could  be  done,  no  dissecting  out 
of  tissues,  or  removal  of  any  considerable  amount  of  flesh ;  for 
example,  in  the  removal  of  the  breast  for  cancer,  it  had  to  be 
cut  out  in  two  or  three  quick  strokes.  All  that  w^as  done  had 
to  be  done  almost  instantaneously.  No  careful  dissection  of  dis- 
eased tissues,  or  of  glands  in  the  neighborhood,  which  might  be 
infected,  was  possible.  Dr.  Agnew  was  so  vividly  impressed 
wdth  the  horror  of  these  operations  that,  quite  frequently,  in 

1  For  example:  Dr.  J.  Marion  Sims  relates  that  in  Georgia,  long  before  tlie  introduc- 
tion of  surgical  anesthesia,  the  young  people  engaged  m  "ether  frolics,"  in  which  the 
use  of  ether  was  pushed  to  a  great  extent,  even  occasionally  to  unconsciousness. 


358  ■  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

describing-  an  operation  performed  before  the  introduction  of 
anesthesia,  his  manner  and  words  showed  that  even  the  lapse 
of  fifty  years,  and  familiarity  with  thousands  of  operations  in 
the  meantime,  had  not  lessened  the  horror  of  these  memories. 

The  surgeons  of  that  day  were  obliged  to  reduce  the 
patients  to  as  near  a  state  of  unconsciousness  as  could  be  safely 
done ;  in  order  to  accomplish  this  they  were  frequently  narco- 
tized with  large  doses  of  laudanum,  or  they  were  even  bled  until 
consciousness  was  nearly  lost.  Then,  limp  and  weak,  the  patient 
was  placed  on  the  operating-table,  his  limbs  being  strapped 
down  so  that  in  his  struggles  he  could  not  move  sufficiently  to 
interfere  ^vith  the  accuracy  of  the  surgeon's  knife,  while  the 
operator  hurriedly  made  the  few  cuts  which  were  essential. 

In  consequence  of  this  state  of  affairs,  the  reputation  of  the 
surgeon  of  that  day  was  dependent  largely  on  his  ability  to  work 
with  great  rapidity  ;  while  liis  operations  were  comparatively 
few  in  number.  The  surgeon  of  tliat  day,  of  necessity,  must 
have  been  far  more  dextrous  than  one  of  the  present.  His  work 
was  tar  harder  than  at  present,  and  the  results  he  obtained  were 
far  less  satisfactory.  It  has  been  said  that  Physick's  reputation 
as  a  surgeon  depended  largely  on  his  quick  and  accurate  cut 
through  the  perineum  in  operating  for  stone  in  the  bladder. 

The  introduction  of  the  use  of  ether  and  chloroform  into 
surgery  changed  all  this  condition  of  affairs.  The  possibility  of 
the  production  of  a  state  of  unconsciousness,  in  which  a  sur- 
geon could  operate  on  his  patient  as  painlessly  as  if  it  were  on 
an  inanimate  object,  made  it  possible  for  the  rapid  and  thorough 
advance  of  surgical  training  and  ability  by  giving  him  complete 
control  of  the  patient  for  a  comparatively  long  period  of  time. 
This  terrific  impetus  given  to  surgery  occurred  just  as  Dr.  Agnew 
was  merging  into  the  great  stream  of  the  medical  profession. 

Dr.  Agnew  saw  the  great  future  opening  in  surgery, 
and  the  fact  that  he  determined  to  take  advantage  of  this 
opportunity  is  shown  in  his  attempts  to  commence  dissecting  in 
the  country  under  such  unfavorable  circumstances  as  have  been 


ESTIMATE    OF    DR.    AGNEW'S   POSITION    IN    SURGERY.  359 

described.  lie  knew  that  such  work  must  make  him  uiijjopu- 
lar  and  his  immediate  future  most  uncertain.  The  opposition 
aroused  among*  his  country  friends  and  patients  and  tlie  con- 
sequent loss  of  practice  only  urged  liim  to  seek  such  a  field 
where  he  could  continue  it  at  a  still  greater  advantage  and  to  a 
fuller  extent.  This  ability  to  grasp  and  keep  up  witli  the  cur- 
rent progress  of  medicine  in  every  department  was  ever  a  most 
marked  characteristic  of  Dr.  Agnew's  disposition.  He  used,  to 
the  last,  the  latest  instruments  and  the  newest  drugs. 

It  has  often  been  remarked,  as  a  matter  of  surprise,  that  in 
a  prescription  of  Dr.  Agiiew  would  often  be  seen  a  drug  or  prep- 
aration which  liad  been  before  tlie  profession  for  a  compara- 
tively short  time,  and  which  many  men  half  his  age  had  not 
yet  learned  to  use.  In  no  point  was  there  a  greater  sign  ex- 
hibited of  this  tendency  on  his  part  than  in  Ids  relation  to  the 
introduction  of  antiseptic  surgery.  Dr.  Agnew,  at  the  time  of 
its  introduction  to  the  profession,  was,  undoubtedly,  in  a  position 
as  a  medical  authority  either  to  aid  or  to  retard  it  considerably. 
The  weight  of  his  great  experience  and  training  would  lune 
had  great  force  not  only  with  liis  students,  but  with  the  medical 
men  of  the  country.  The  fact  is  well  known  that  Dr.  Agnew 
was  one  of  the  first  to  adopt  thoroughly  and  fully  all  the  pre- 
cepts and  practices  of  antiseptic  surgery.  He  saw  at  once  the 
great  advantages  to  be  derived  from  its  application,  and  he  was 
its  most  enthusiastic  advocate. 

The  advantages  of  the  training  of  such  a  scliool  as  the 
School  of  Anatomy  to  a  surgeon  have  been  stated  elsewhere. 

The  conflict  of  the  great  Civil  War,  with  its  thousands  of 
wounds  and  injuries,  with  its  innumerable  diseases  caused  by 
the  life  necessarily  led  by  soldiers,  was  another  great  oppor- 
tunity to  Dr.  Agnew.  It  came  also,  fortunately,  at  a  time  of 
life  when  he  was  fully  prepared  to  meet  its  tremendous  exactions, 
and  when  his  reputation  was  sufficient  to  enable  him  to  grasp 
readily  the  positions  necessary  to  exercise  his  skill.  At  the. 
beginning  of  the  War  he  stood  as  a  clear-headed  and  careful 


360  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

anatomist  and  a  skillful  surgeon.  His  appointment  at  the 
Mower  Hospital,  Chestnut  Hill,  where  he  saw  constantly  thou- 
sands of  gunshot  wounds  daily,  and  where  their  course  and 
treatment  were  brought  thoroughly  to  his  mind,  was  but  a 
natural  selection  of  the  most  eminent  man  for  the  position.  He 
was,  at  that  time,  only  about  forty  years  of  age,  but  already  one 
of  the  leading  surgeons  of  the  country. 

Again,  in  other  connections.  Dr.  Agnew  was  fortunate  in 
the  time  of  his  birth.  In  his  early  days  there  was  no  such  strict 
division  between  medicine  and  surgery  as  exists  to-day.  In 
consequence,  Dr.  x\gnew's  medical  training  was  fully  as  thor- 
ough and  complete  as  his  surgical,  and  he  was  vahied  until  his 
death  as  a  most  skillful  and  competent  consultant,  in  many  con- 
ditions purely  medical  in  their  nature.  At  the  same  time,  some- 
what later  in  his  career,  there  was  yet  no  division  of  the  specialties 
among  surgeons,  and  Dr.  Agnew  was  at  one  time  a  distinguished 
gynecologist,  ophthalmologist,  a  genito-urinary  specialist,  and  a 
syphilographer,  as  well  as  a  leading  authority  on  gunshot  wounds, 
on  orthopedics, — in  fact,  on  everything  in  surgery.  Undoubt- 
edly, the  field  of  general  medicine  and  general  surgery  has 
grown  too  broad  for  such  specialists  on  everything  to  exist  again. 
Those  who  are  pursuing  specialties  are  going  so  deeply  into 
their  subjects,  and  are  becoming  so  unusually  expert  at  their 
work,  that,  doubtless,  no  one  man  can  hope  to  compete  with 
them  in  their  special  lines  of  work.  This  was  one  of  the  corol- 
lary results  that  followed  the  admission  of  Dr.  Agnew  into 
medicine. 

His  pre-eminent  position  in  surgery  was  shown  to  the 
American  world  when  he  was  selected  as  President  Garfield's 
chief  consultant.  Tlie  chance  for  such  a  demonstration,  fortu- 
nately, never  occurred  before  in  the  history  ot  American  surgery. 

Of  course,  his  fortunate  time  of  birth  and  his  fortunate 
career  cannot  be  ascribed  in  any  way  to  luck.  He  reached  his 
goal  through  the  most  distressing  and  discouraging  of  circum- 
stances.    The  first  fifteen  years  of  his  professional  life  seemed 


ESTIMATE    OF    DU.    AGNEW'S    POSITION    IN    SURGERY.  361 

to  him  to  liave  been  spent  in  a  fruitless  and  unsatisfactoiy 
search  for  a  proper  field.  The  fact  that  such  great  opportu- 
nities existed  should  not  blind  our  eyes  to  the  equally  important 
fact  that  ])r.  Agnew  was  great  enough  to  seize  his  opportuni- 
ties. To  show  how  rare  a  combination  this  was,  it  is  only 
necessary  to  note  how  few  of  his  colleagues  accomplished  similar 
results. 

As  a  man  and  as  a  physician  he  was  thoroughly  honored. 
His  calm,  grave  face,  so  ready  to  light  into  a  smile,  and  never 
wanting  its  kindly  aspect,  will  ever  remain  in  the  hearts  of  his 
admirers.  He  was  never  morose,  never  discouraged;  always 
calm  exteriorly,  yet,  after  forty  years  of  continuous  teaching,  he 
was  agitated  by  an  approaching  lecture.  He  was  very  reticent 
and  undemonstrative,  yet  always  cheerful — a  cheerfulness  born 
of  his  love  of  God,  his  profession,  and  his  fellow-men.  It  was 
pain  for  him  to  be  unable  to  do  a  friendly  act. 

Dr.  Agnew  was  thoroughly  honest  in  thought,  in  speech, 
and  in  action.  He  was  honest  as  a  surgeon ;  he  always  did  the 
thing  which  he  believed  to  be  the  best  for  his  patient.  He  had 
no  jealousies.  His  hand  was  ever  ready  to  assist  the  weak  and 
struggling  practitioner,  and  the  profession  of  Philadelphia  was, 
through  him,  raised  to  a  higher  plane.  His  success  in  life  was 
achieved  not  by  any  sudden  turn  of  fortune,  but  by  patient 
industry,  by  tireless  application,  by  wise  judgment,  by  thorough 
knowledge,  by  consummate  skill,  and  by  honest  purpose  of  word 
and  act.     He  was  never  ostentatious  in  anything. 

One  point  in  Dr.  Agnew's  character  which  strikes  most 
forcibly  is  the  fact  that  he  had  but  few  qualities  considered 
in  this  day  to  be  necessary  to  success.  Young  men  are 
admonished  tliat  the  way  to  be  successful  is  to  be  grasping, 
selfish,  and  pushing,  and  insensibly  they  grow  up  with  the  idea 
of  each  man  for  himself;  but  here  was  a  man  who  achieved 
success  in  life  by  a  diametrically  opposite  course.  He  was 
modest,  retiring,  kind,  gentle,  and  devoid  of  all  ambition. 
Truth  was  the  object  of  his  search ;  he  endeavored  to  ascertain 


362  LIFE    OF    D.    HATES    AGXETT,    M.D.,    LL.D. 

the  facts  and  draw  the  right  inferences ;  justice  was  the  bed- 
rock of  his  character. 

There  was  a  singular  purity  about  his  very  presence ;  God 
gave  him  natural  gifts  of  a  high  order,  and  he  had  a  perfect 
body.  He  owed  his  success  laro-elv  to  a  sinsfular  balance  of 
mental  and  moral  qualifications.  Xovelties  never  too  much 
tempted  nor  too  much  repelled  him.  He  was  intellectually 
very  honest.  The  surgeon  is  sometimes  apt  to  become  dramatic, 
to  love  display  of  his  own  skill.  Dr.  Agnew  had  none  of  this. 
He  once  said  that  ••  the  immense  amount  of  unpaid  service  to  phy- 
sicians and  their  families  was  hard  on  busy  people;  but  then," 
he  added,  "  it  is,  after  all,  a  great  help  to  one's  self.  "\Ve  ought 
to  be  thankful  that  we  are  not  always  making  mere  money." 

]Many  men  change  radically  as  life  goes  on  ;  but  Agnew 
was,  from  first  to  last,  young  or  old,  the  same  man.  A  certain 
simplicity  was  in  all  his  ways ;  the  outcome  of  action  from 
belief  was  fearless  and  unquestioning. 

In  our  American  world,  given  to  haste,  to  pressure,  and  to 
longing  for  speedv  results  and  quick  returns,  he  stood  a  crown- 
ing example  of  those  patient  and  persevering  powers  which 
moved  steadily  to  an  appointed  end  without  haste  and  without 
rest.  In  a  self-seeking,  grasping  age  he  never  swerved  from 
the  high  standard  of  a  self-sacrificing  profession.  In  days 
given  to  self-advertisement  he  patiently  waited,  without  self- 
assertion,  until  fame  came  as  the  fit  fruit  of  the  union  of  genius 
and  character.  Years  were  needed  to  make  his  worth  known 
and  to  round  out  the  full  measure  of  public  and  professional 
recoo^nition.  but  it  came,  in  later  vears.  in  an  overflowins:  flood. 

Dr.  Agnew  always  intimated  the  idea  that  his  profession 
was  ••  a  calling,"  that  the  healing  of  his  fellow-men  was  not  only 
the  practice  of  medicine,  but  a  sacred  duty.  He  felt  liimself, 
in  a  sense,  a  trustee  of  his  vast  knowledge  and  wonderful  skill. 
He  did  not  regard  them  as  commodities  commanding,  by  reason 
of  their  rarity,  the  highest  market-price.  He  did  not,  in  short, 
make  his  fees   parallel   with   the   inflection    of  his   reputation. 


ESTIMATE    OF    DR.    AGXEW's    POSITION    IN    SUUGEUY.  363 

Undoubtedly,  if  he  could  liave  afforded  it,  lie  would  have  done 
his  work  without  remuneration. 

lie  was  possessed  of  great  natural  ability  and  strong  com- 
mon sense  ;  these  traits  would  have  given  him  eminence  in 
whatever  vocation  he  might  have  followed ;  had  he  continued 
in  business  he  would  ultimately  have  become  a  great  and  far- 
seeing  financier ;  had  he  turned  to  legal  pursuits  he  would  have 
been  a  judge  on  the  bench,  learned  in  the  law  ;  or,  drifting  in  a 
political  life,  a  senator  ;  had  he  been  a  theologian  he  \Aould  have 
been  a  moderator  of  assembly,  or,  in  other  church  relations, 
would  have  graced  an  Episco[)al  Chair. 

In  no  profession  or  vocation  in  life  are  there  more  varied, 
or  different,  or  stronger  attributes  required  than  go  to  make  up 
tlie  elements  necessary  for  the  production  of  a  successful  prac- 
tising physician.  Many  professions  or  vocations  overlap,  in  their 
requisites,  the  essentials  in  medicine  ;  but  none  require  more. 
In  the  first  place,  a  physician  requires  a  great  natural  endow- 
ment of  intelligence.  Without  it,  under  the  veneer  of  pleasant 
or  polished  manners,  a  certain  degree  of  success  can  be  attained, 
but  no  commandhig  height  can  be  reached. 

Again,  a  great  degree  of  manual  dexterity  is  needed, 
especially  in  the  surgeon.  A  great  surgeon  must  be  a  great 
mechanic.  He  must  be  as  adept  in  the  use  of  his  hands  and  in 
the  various  laws  of  mechanics  as  a  carpenter,  a  sculptor,  or  a 
mechanical  engineer.  Again,  he  must  possess  the  most  imper- 
turbable manner, — must  not  be  upset  or  disturbed  by  anytliing. 
He  is  expected  to  be  cool,  collected,  and  active  in  the  most  start- 
ling or  sudden  emergencies.  He  must  possess  more  or  less  of 
an  agreeable  manner  and  pleasant  appearance.  Of  course,  as  a 
physician  grows  older  and  his  real  worth  is  better  known,  this 
is  not  so  essential ;  but  in  the  young  physician  this  is  absolutely 
demanded.  He  must  possess  concentration.  He  must  be  able 
to  reach  conclusions  definitely  and  quickly,  from  the  ^•arious  data 
which  are  presented  to  his  mind.  He  must  proceed  to  formulate 
his  diagnosis  like  an  arithmetician  working  out  a  problem.     He 


364  LIFE    OF    D.    HAYES    AGNEW,    M.D.,    LL.D. 

must  be  willing  to  work  at  all  times,  day  and  niglit ;  to  expose 
himself  to  all  sorts  of  dangers  and  hardships, — in  short,  to  live 
a  life  in  which  the  precepts  which  he  teaches  are  almost  entirely 
disregarded.  He  must  expect  to  do  a  large  proportion  of  his 
work  withoiit  hope  of  remuneration, — in  fact,  he  can  never 
look  forward  to  any  extraordinary  degree  of  income. 

As  he  becomes  more  in  demand  he  will  be  able,  only  to  a 
sliffht  extent,  to  use  assistants  or  substitutes.  It  is  himself  and 
his  own  opinion  that  are  wanted ;  and  he  is  unable,  as  in  other 
vocations,  to  employ  a  corps  of  workers  to  aid  him  in  his  daily 
work.  Of  course,  to  a  certain  extent,  this  can  be  done,  but  not 
at  all  as  it  is  done  in  many  other  professions. 

On  the  other  hand,  the  advantages  of  such  a  position  as 
that  held  by  Dr.  Agnew  were  equally  great.  He  was  beloved 
by  every  one ;  his  words,  deeds,  and  thoughts  were  quoted  and 
copied  everywhere  as  almost  infallible.  To  the  American 
world,  who  dearly  loves  a  hero,  he  stood  the  ideal  of  the  prowess- 
of  the  American  surgeon.  The  name  of  Agnew  has  always  been 
associated  with  the  description  of  the  great  Larrey,  the  French 
surgeon,  by  Napoleon :  "  He  was  the  best  man  I  ever  knew." 

The  extraordinary  reputation,  honor,  and  romantic  position 
of  Dr.  Agnew  in  the  world  of  medicine  was  not  without  it& 
effect  upon  his  profession.  He  placed  the  ideals  of  the  profes- 
sion upon  the  highest  levels,  where  they  will  permanently  remain. 
For  his  life-work,  the  accomplishment  of  this  object  was  enough 
in  itself  alone.  The  American  public  have  been  taught  by  his 
example  what  a  physician  can  be. 

His  fame,  attracting  the  eye  of  young  America,  has  created 
a  gveat  furore  for  surgery.  The  aspiring  collegian  looking  for 
a  profession  is  frequently  influenced  to  take  up  medicine,  and 
particularly  surgery,  as  a  life-work,  simply  from  his  impressions 
of  Dr.  Agnew.  Undoubtedly  Dr.  Agnew's  reputation  has  caused 
the  surgical  world  to  be  filled  to  overflowing  by  aspiring  appli- 
cants. It  has  given  an  impetus  to  American  surgery  which  will 
redound  forever  to  the  credit  of  the  New  World. 


APPENDIX. 


Credits  for  Material  Used  in  the  Agnew  Biography. 

In  i)i-epariiiii,-  this  l)iogni|)liy  it  was  tlio  olyect  of  the  writer  in  all 
cases  to  go  to  the  original  sources  for  obtaining  data.  In  all  cases  where 
it  has  been  possible  this  has  been  done.  In  obtaining  this  material  it  has 
been  verified  or  disproved  by  i)arallel  comparison  as  fully  as  possible. 
This  was  possible  to  do,  as  nearly  every  bit  of  information  has  been 
received  from  two  or  more  wholly  different  sources. 

Of  course,  the  greater  part  of  the  material  comes  directly  from  Dr. 
Agnew  himself,  or  from  material  furnished  by  Mrs.  Agnew.  In  all  cases 
of  dispute  Mrs.  Agnew  has  been  the  judge,  and  to  her  judgment  has 
been  submitted  every  point  of  dispute.  Thanks  are  due  to  Mrs.  Agnew 
for  this  service  which  she  has  rendered,  especially  as,  being  in  [)oor 
health,  she  has  fulfilled  the  painful  duty  of  exitmining  and  verifying  the 
story  of  her  husband's  life,  in  order  to  get  it  into  proper  shape  for  this 
biography.  Without  her  assistance  much  of  the  record  would  be  totall}^ 
wanting. 

Dr.  Agnew's  lectures,  private  notes,  books,  and  letters  have  been 
carefull}'  gone  over  in  order  that  nothing  might  be  missed  which  could 
be  with  propriety  included. 

Credit  is  due  to  the  following  books  from  which  information  was 
obtained  : — 

The  Homes  of  Family  Names,  hy  H.  B.  Guppy. 

The  Origin  and  Signification  of  Scottish  Surnames,  hy  Cliflbrd 
Stanley  Sims. 

The  Genealogical  and  Heraldic  Genealogy  of  the  Peerage  and 
Baronetage,  by  Sir  Bernard  Burke. 

Debrett's  Peerage,  Baronetage,  Knightage,  and  Companionage, 
1892,  nOth  year  of  publication. 

Men  of  Mark  of  Cumberland  Valley,  Pennsylvania,  1TT6-1876,  by 
Alfred  Nevin,  D.D..  LL.D. 

Strong  Bow's  Conquest  of  Ireland,  edited  by  Francis  P.  Barnard, 
M.A.,  London,  1888. 

English  History-  from  Contemporary  Writers. 

Colgrave's  History  of  the  Norman  Conquest. 

Chambers'  Lives  of  Eminent  Scotchmen. 

Dictionary  of  National  Biography,  MacMillan  &  Co. 

(365) 


366  APPENDIX. 

Biographical  Encyclopseclia  of  Pennsj^lvania  of  the  Nineteenth 
Century. 

Hereditarj^  Sheriffs  of  Gallowa}',  b}-  Sir  Andrew  Agnew.  For  a  cop}'' 
of  this  extremely  rare  and  interesting  book,  thanks  are  due  to  the  son 
of  the  author,  the  present  Sir  Andrew  Noel  Agnew.  The  bogk  has  been 
given  to  the  Historical  Society  of  Pennsjdvania,  where  it  may  be  con- 
sulted by  those  desiring  to  study  the  histor}^  of  the  Agnew  famih'  more 
in  detail. 

The  Biographical  Outline  of  tlie  American  Agnew  Familj',  compiled 
by  Smith  Agnew  (unpublished).  For  the  opportunit3^  to  study  these 
sets  of  remarkably  complete  genealogical  tables,  thanks  are  due  to  his 
grandson,  Mr.  Smith  Agnew,  of  Pittsburgh. 

Carson's  History  of  the  Medical  Department  of  the  Universit}'  of 
Pennsylvania. 

Catalogues  of  the  Universit}^  of  Pennsylvania,  1830-1892. 

Philadelphia  Hospital  Report,  vol.  i. 

Reports  of  Philadelphia  Hospital  to  Board  of  Guardians,  1856-1870. 

History  of  Chester  Count}^,  b}'  J.  Smith  Futhe}'. 

Histor}'^  of  Lancaster  County,  bj^  Franklin  Ellis  and  Samuel  Evans. 

History  of  Philadelphia,  by  Scharf  and  Westcott. 

History  of  Delaware,  by  Scharf. 

History  of  Jefferson  College. 

Gross'  Autobiography'. 

Sims'  Story  of  My  Life. 

In  addition  to  these  works,  thanks  are  due  to  Mrs.  Mary  A.  Wallace, 
of  East  Earl,  Pa.,  and  her  daughter,  Mrs.  Mary  A.  Falls,  of  New  Castle, 
Pa.,  Dr.  Agnew's  half-sister,  and  her  daughter,  and  to  Mrs.  Mary  Irwin 
Agnew,  niece  of  Dr.  Agnew,  and  Miss  Martha  A.  Agnew  Stuart. 

In  the  description  of  the  student  life  at  the  University  from  1835  to 
1840,  thanks  are  due  to  Dr.  Alfred  Stille,  of  Philadelphia,  and  Dr.  Traill 
Green,  of  Easton,  Pa.,  eacli  of  whom  prepared  a  special  original  article 
on  this  subject  for  this  biography. 

Thanks  are  also  due  to  Dr.  James  L.  Tyson,  of  Penllyn,  Pa.,  who 
prepared  the  description  of  Dr.  Agnew  as  a  student  at  tills  period.  Dr. 
W.  S.  W.  Ruschenberger  also  supplied  some  interesting  reminiscences 
which  have  been  used. 

Credit  is  due  to  Iron  Making  and  Coal  Mining  in  Pennsylvania, 
by  James  M.  Swank,  for  verification  of  much  of  the  material  collected 
from  family  stories  and  from  a  survey  of  the  business  world  of  this 
period. 

The  History  of  the  Philadelpliia  School  of  Anatomy,  a  lecture  de- 
livered by  Dr.  W.  W.  Keen,  Marcli  1,  1875,  at  the  closing  of  the  school, 


APPENDIX.  367 

forms  the  basis  from  which  has  Leeii  prepared  the  history  of  the  connec- 
tion of  tlie  different  teachers  of  tliis  school,  with  tlie  excei)tion  of  Dr. 
Agiiew,  down  to  1875.  The  story  of  Dr.  Agnew's  connection  with  tliis 
school  has  l^een  i)re[)ared  from  many  dilferent  sources;  among  tliem, 
from  a  pai)er  prepared  on  this  subject  by  Dr.  James  E.  Garretson,  and 
from  information  furnished  ])y  twoof  Dr.  Agnew's  former  demonstrators 
of  anatomy,  Dr.  Robert  Boiling,  and  Dr.  John  W.  Lodge.  The  history 
of  the  school  since  1875  is  compiled  from  the  owners  of  the  school  at 
the  periods  mentioned. 

The  account  of  Dr.  Agnew's  connection  witli  tlie  Philadelphia  Hos- 
pital was  prepared  from  his  own  data,  and  from  the  original  records  of 
the  hospital,  through  courtesy  of  Dr.  Charles  K.  Mills, 

The  official  report  of  Dr.  Agnew's  services  during  the  Civil  "War 
was  furnished  from  the  records  in  the  Surgeon-General's  office  in  Wash- 
ington, through  the  courtesy  of  Dr.  John  S.  Billings,  IT.  S.  A.,  and 
Deputy  Surgeon-General  Charles  R.  Greenleaf.  Drs.  Lodge  and  Morton 
also  furnished  data  in  this  connection. 

Dr.  Agnew's  connection  with  the  L^niversity  of  Pennsylvania  was 
prei)ared  from  the  minutes  of  the  meetings  of  the  Trustees  of  the  Univer- 
sit}^  of  Pennsylvania,  through  the  courtesy  of  the  Rev.  Jesse  Y.  Burke, 
and  from  the  minutes  of  the  meetings  of  the  Facult}'  of  the  Medical  De- 
partment, furnished  through  the  courtesy  of  the  gentlemen  composing 
this  distinguished  body.  To  Mr.  William  H.  Salvador  thanks  are  also  due 
for  the  use  of  his  inexhaustible  su[)ply  of  information  on  this  subject. 

The  account  of  Dr.  Agnew's  connection  with  the  Wills  Eye  Hospital 
was  prepared  from  data  furnished  by  Dr.  Charles  A.  Oliver. 

Dr.  Agnew's  connection  with  the  Pennsylvania  Hospital  was  written 
from  material  furnished  by  Mr.  Benjamin  H.  Shoemaker,  President  of 
the  Board  of  Managers  of  that  institution. 

The  account  of  Dr.  Agnew's  connection  with  the  Orthopedic  Hospital 
was  prepared  from  data  furnished  b}^  Dr.  Frank  S.  Penrce. 

The  estimate  of  Dr.  Agnew's  services  in  the  Facultj'  of  Medicine 
was  written  by  Dr.  William  Pepper. 

The  article  by  Dr.  De  Forest  Willard  on  the  life  of  Dr.  Aguew  has 
been  freely  quoted,  as  has  also  a  similar  one  by  Dr.  John  Ashhurst,  Jr., 
puulished  in  the  International  Clinics  for  July,  1892. 

The  material  used  in  the  G.-irfield  case  was  prepared  from  the 
original  notes  of  the  case  as  written  by  the  nttending  physicians.  To 
Dr.  Robert  Reyburn  thanks  are  due  for  the  privilege  of  examining  these 
documents.  Dr.  Bliss'  article  in  tlie  New  York  Medical  Record  and  the 
editorial  comments  in  the  same  journal  have  also  been  used  when 
essential. 


:368  APPENDIX. 

The  account  of  the  jubilee  of  Dr.  Agnew  was  taken  from  the  original 
manuscript  in  the  hands  of  the  speakers  and  writers. 

For  various  facts  and  data,  thanks  are  due  to  Drs.  Wharton  Sinkler, 
Frederick  P.  Henr}^,  Wm.  M.  Capp,  James  Tyson,  J.  M.  Da  Costa, 
Francis  E.  White,  Lewis  A.  Sayre,  Wm.  Goodell,  H.  C.  Wood,  John 
Marshall,  R.'A.  Cleeman,  S.  Weir  Mitchell,  Thomas  S.  Neilson,  J.  Ewing 
Mears  ;  also  to  Messrs,  Coleman  Sellers,  Crawford  Arnold,  J.  Simpson 
Africa,  Hon.  Andrew  G.  Curtin,  Gregory  B.  Keen,  Col.  A.  J.  Rockwell, 
'  Henry  Chapman,  A.  J.  Cassatt,  Mrs.  James  A.  Garfield,  Jos.  H.  Swain, 
Rev.  E.  R.  Craven  ;  Frederick  D.  Stone,  Librarian  of  the  Historical 
Society ;  Manzo  Kushida. 


NDEX. 


Abolishment  of  liereditable  jurisdictions,  16    M 
Abolition  of  slavery,  speech  on,  129 
Abolitionists,  128 
Abraham  Lincoln,  128 
Academy  of  Surgery,  271 

annual  oration  before,  271 
Accident,  run-away,  73 

while  fox-huntmg,  57 
Adams,  J.  H.,  315 

Margaret  Agnew,  250 
Address,  at  banquet  to  Dr.  Gross,  298 
at  funeral  of  Dr.  Agnew,  311-351 
by  Dr.  Agnew  on  retirement  from  Uni- 
versity, 331 
valedictory,  116-126 
Addresses,  at  jabilee,  301-307,  315 
by  Dr.  J.  M.  Da  Costa,  302 
by  Dr.  Lewis  A.  Sayre,  308 
by  Dr.  R.  A.  Cleeman,  312 
by  Prof.  Samuel  W.  Gross,  315 
by  Provost  Pe|iper,  315 
by  William  R.  Lincoln,  315 
before  American   Surgical  Association, 
197-219,  268 
Agneaux,  a  village  in  Northern  France,  1,  2 
derived  from  the  Latin  term  agnus,  1 
family  name  derived  from,  1 
Norman-French  for  "  laml),"  1 
Agneaux,   d',  Jean   Jacques   Rene   de   Ste. 
Marie,  4 
Marquis  de  Ste.  Marie,  2 
Sir  Fulke,  •! 
Sir  John,  4 
Sir  Philip,  4 
Sir  William,  4 
Ste.  Marie,  4 
Agneaux,  heraldic  achievements  of  the,  3 

Robert  and  Antoine,  4 
Agneaux  de  I'lsle,  3,  6 

descendants  of,  4 
Agnew,  a  town  m  Nebraska,  1 
Andrew,  10 
Benjamin  S.,  34 
Cornelius  R  ,  34 
Daniel,  34,  135 
David,  24,  63 

descendants  of,  24 
David  Hayes,  21,  25,  36 
Dr.  D.  Hayes,  year  of  birth,  19 

year  of  death,  19 
Erwin,  33 

family,  American  branch  of,  23 
baronetage  of,  17 

24 


new  family,  coat  of  arms  of,  19 
earliest  record  of,  1 
great  height  and  splendid  physique 

of,  22 
knighthood  of,  17 
lineage  of,  1 
prolitic  offspring,  23 
prominence  in  religious  matters,  23 
prominent  in  early  history  of  Amer- 
ica, 21 
royal  de.scent  of.  11 
Scotch  branch  of,  5 
General  James,  14,  29,  30 
James,  21,  23 

descendants  of,  24 
John  Holmes,  33,  41,  126,  135 
John  P.,  63 
Patrick,  11 

Prof.  John  Holmes,  135 
Rev.  David  C.  A.,  3 
Rev.  Dr.  Benjamin  L.,  301 
Rev.  John  Holmes,  41,  126 
Robert,  Dr.  Agnew's  father,  25,  26 

description  of,  26,  27 
Samuel,  21 

Sir  Andrew,  10,  11,  18,  126 
Sir  Andrew  Noel,  19 
Sir  Patrick  and  descendants,  18 
Smith,  23 
Surgical  Society,  271,  341 

its  banquets  272 
various  ways  of  spelling,  1 
;new,  a  brilliant  conversationalist,  253 
a  "  born  doctor,"  36,  39 
a  charming  host,  253 
a  consistent  Christian,  264 
a  Christian  from  childhood  up,  38 
a  Consulting  Surgeon    to   the  Presby- 
terian Hospital,  275 
a  famous  sj'vort^sman,  55 
a  Fellow  of  the  American  Surgical  As- 
sociation, 268 
a  good  judge  of  a  horse.  58 
a  life-long  Democrat,  336 
a  member  of  Board  of  Directors  of  the 

Union  Trust  Company,  274 
a  member  of  the  American  Philosoph- 
ical Society  for  Promoting  Useful 
Knowledge,  275 
a   member   of  the  Franklin  Institute, 

275 
a  member  in  the  Board  of  Managers  of 
the  House  of  Refuije,  126,  273 

(369) 


370 


INDEX. 


Agnew,    a    member    of    the    Philadelphia  1  Ai 
County  Medical  Society,  126  | 

a  member  of  the  American  Colonization 
Society,  128 

a  member  of  the  Medical  Examining 
Board  for  Volunteer  Surgeons,  131 

a  member  of  the  Medical  Society  of  the 
State  of  Pennsylvania,  268 

a  member  of  the  A  M  n  fl,  273 

a  member  of  the  Faculty  of  Medicine  in 
the  University  of  Pennsylvania, 
139,  152,  156 

a  society  named  after,  271 

a  strict  Calvia  Presbyterian,  258 

a  student  at  Jefferson  College,  Cannons- 
burgh,  Pa.,  40 

a  student  at  Newark  College,  Del.,  41 
record  of  his  experience  there,  41 

a  student  at  the  University  of  Pennsyl- 
vania, 42 

a  tireless  worker,  256 

a  Trustee  of  the  Philadelphia  Dental 
College,  275 

abstemious  with  food  and  drink,  252 

again  locates  in  Philadelphia,  73 

ambidextrous,  169 

an  ideal  teacher  of  surgery,  157 

an  example  of  punctuality,  169 

an  early  riser,  251 

appointed  Surgeon  of  Volunteers,  131 

approved  of  pure  humor,  253 

as  a  lecturer,  49,  138,  155,  166,  318 

as  a  publisher,  193-196 

as  a  surgeon,  164 

as  a  svj-ihilographer,  160 

as  a  writer,  113-116,  193-219 

as  Acting  Assistant  Surgeon  in  the 
United  States  Army,  131 

as  an  expert  in  medico-legal  cases, 
285 

as  an  operator,  166 

as  consulting  surgeon,  131,  152,  165 
at  Mower  General  Hospital,  131 

as  Curator,  113 

as  Demonstrator  of  Anatomy  in  the 
University,  138 

as  Professor  of  Surgery,  154-172 

assisting  his  father  in  his  practice,  54 

at  the  battle-field  of  Gettysburg,  133 

attracted  to  clergymen,  258 

averse  to  gossip,  253 

banquet  to,  300 

before  the  State  Legislature,  158 

changes  his  residence,  153 

comes  to  Philadelphia,  72 

death  of,  340 

decides  to  become  a  surgeon,  70 

description  of  in  1838,  51,  52 

disliked  by  country  people  because  of 
his  method  of  studying  anatomy,  71 

duck-shooting,  57,  58 


;new,  elected  Attending  Surgeon  at  Penn- 
sylvania Hospital,  144,  145 
Attending  Surgeon  at  Wills'  Eye  Hos- 
pital, 142 
Professor  of  Clinical  and  Demonstra- 
tive Surgery,  139,  141 
Emeritus  Professor  of  Surgery  at  Uni- 
versity, 276 
establishes   the   Pathological   Museum, 

113 
fond  of  hymns,  263 

of  medical  students,  271 
of  reading,  252,  254 
fox-hunting,  56 
funeral  of,  341 
gives  up  practice,  55 

reasons  for,  60 
gold  medal  presented  to,  315 
had  friends  everywhere,  254 
Honorary  Professor  of  Clinical  Surgery 

at  Universit}',  276 
Honorary  Surgeon  to  the  Presbyterian 

Hospital,  275 
in  the  Garfield  case,  224,  249 
Orthopedic  Hospital,  108,  149 
Pennsvlvania  Hospital,  107 
Philadelphia  Hospital,  107 
School  of  Anatomy,  76 
University  Hospital,  108 
Wills  Eye  Hospital,  108 
joins  the  College  of  Physicians,  126,  267 
locates  in  Soudersburg,  73 
loved  to  entertain  his  friends,  253 
made  Emeritus  Surgeon  to  Wills'  Eye 

Hospital,  142 
meets  with  a  run-away  accident  and  is 

seriously  injured,  73 
not  opposed  to  the  higher  education  of 

women,  148 
one  of  the  founders  of  the  Atheneum 

Literary  Society,  41 
operating  at  Geneva,  250 
plain  in  his  dress,  255 
practising  at  Cochranville,  70 
at  Kobleville,  55 
at  Pleasant  Garden,  55 
President  of  the  American  Surgical  As- 
sociation, 268 
of  the  ]\Iedical  Society  of  the  State- 
of  Pennsylvania,  268 
progressive,  359 

receives  honorary  degrees  of  A.M.  and 
LL.D.  from  'Princeton  College,  159 
returns  again  to  medicine,  70 
seemed  always  young,  256 
sickness  of,  339 

speaks  on  the  abolition  of  slavery,  129" 
studying  anatomy,  52.  71 
Surgeon-in  Charge  at  Hestonville  Gen- 
eral Hospital,  131 
"  the  doctors'  doctor,"  302 


INDEX. 


371 


Agnew,  tolerant  in  religions  beliefs,  258 
town  of  Agnew,  Nebraska,  named  in 

honor  of,  1 
tribute  of  respect  to,  284 
Vice-President   of  Alumni   Society   of 
Medical  Dei>artment  of  University 
of  Pennsylvania,  275 
well  acquainleii  with  theology,  258 
well  known   to  the   profession  in   Eu- 
rope, 336 
well  received  in  Philadelphia,  106 
Agnew's  address,  at  banquet  to  Dr.  Gross, 
298 
before  the  American  Surgical  Asso- 
ciation, 268 
on  cranial  and  heart  wounds,  197-206 
on  relation  of  social  life  to  surgical 

disease,  207-219 
on  retirement  from  the   University, 
331 
addresses  at  jubilee,  304-307,  315 
annual  visit  to  ]iarents,  69,  70 
appointment  as  Professor  of  Surgery  at 
the  University,  154 
at  the  Orthopedic  Hospilal,  149 
attendance  on  General  Winfield  S.  Plan- 
cock,  133 
on  President  James  A.  Garfield,  224- 
249 
Mrs.  Garfield's  estimate  of,  247 
belief  in  divine  guidance,  257 
birth,  25 
birthnlace,  26 

boyish  life  in  the  country,  39 
business  venture,  60,  75 
calm  exterior,  361 

cheerfulness  and  forbearance,  261,  262 
classical  education,  39 
class-mates  and  fellow-graduates,  50,  51 
connection  with  hospital  duties,  107 
with    the     Philadelphia    School    of 

Anatomy,   76,  105 
witii  the  Pleasant  Garden  Iron-Works, 
60-69 
courtshi])  and  marriage,  54,  55 
degrees,  337 
dislike  for  compliments,  259 

towanl  the  mixed  clinique,  148 
duty  to  his  patients  a  sacred  trust,  259 
early  life,  36 

in  Philadelphia,  106-127 
education  at  Jefferson  College,  Cannons- 
burgh,  Pa.,  40 
European  trip,  250 
experience  as  a  country  physician,  55 
first  appointment  at  tiie  University  of 

Pennsylvania,  136 
first  meeting  with  his  future  wife,  38 
freshness  and  enthusiasm,  256 
graduating  thesis,  53,  54 

destroyed  during  fire  at  University,  53 


Agnew's  graduation,  50 

Plaverford  home,  251 

home-life,  250-264 

ingenuity,  174 

jubilee,  298 

kindness  of  heart,  132,  265 

last  appearance  at  a  public  meeting,  337 

last  didactic  lecture,  321-331 

later  life,  267-297 

life  from  1860  to  1870,  128-153 

love  for  his  wife  and  family,  35,  261,  265 

love  for  the  study  of  anatomy,  52 

magnificent  constitution,  256 

most   important   position   in  operative 
work,  113 

objection  to  female  students,  145 

observance  of  the  Lord's  Day,  257 

original  investigations,  177-192 
work  in  surgery,  173-192 

parents,  25.  39 

description  of,  26-29 

personal  appearance,  165 

portrait  (frontispiece),  314 

position  in  surgery,  estimate  of,  353-364 

presents  from  his  admirers,  259 

jirogress,  107 

relatives  prominent  in  history  of  Penn- 
sylvania, 29-34 

respect  for  American  medicine,  251 

retirement  from  the  University  of  Penn- 
sylvania, 318-338 

return  to  Nobleville,  54 

school  days,  37 

separation  from  the  School  of  Anatomy, 
105 

services  as  a  surgeon,  estimate  of,  171 

sickness,  death,  and  funeral,  339-352 

splendid  physique,  255 

summer  trips,  254 

"  Surgery,"  160,  281 

valedictory  addresses,  116-126 

writings,  193 
"  Agnew's  Hill,"  6 
Agnews,  American,  genealogy  of,  23 

of  Lochnaw,  16,  22 

of  Pennsylvania,  21,  22 

of  the  South,  21 
Alaric,  123 

Alencourt.s,  line  of  the,  4 
Almshouse  Hospital,  47 
Alumni  Society  of  Medical  Department  of 

University  of  Pennsylvania,  275 
Ambidexterity,  170 
American  Colonization  Society,  128 

Philosophical    Society    for    Promoting 
Useful  Knowledge,  275 

physicians,  356 

surgery,  Nestor  of.  269 

Surgical    Association,  addresses  before, 
197-268 
Amusing  story  of  "  Blockley,"  109 


372 


INDEX. 


Anatomical  dissections,  53 
"Anatomy  Acts,"  90 
Andrew  Agnew,  10 
Anecdotes,  276 

of  Dr.  Agnew's  boyhood  days,  36-39 
Anesthesia,  357 
Appendix,  365—368 
Armorial  bearings',  3,  4 
"  Armorial  de  France,"  4 
Articles  and  books  published  by  Dr.  Agnew, 

193-196 
Athenenm  Literary  Society,  41 
Atlee,  Dr.  Walter  F.,  252 
Autopsy   on   President   James  A.  Garfield, 
233-235 

Banquet  to  Dr.  Gross,  address  at,  298,  299 
Banquets  at  Agnew  Surgical  Society,  272 

to  Dr.  Agnew,  addresses  at,  300-317 
ode  read  at,  312 
poem  read  at,  309 
'  song,  written  by  J.  H.  Adams,  315, 
316 
music  to,  by  Hugh  A.  Clarke,  316 
Barnes,  Surgeon-General,  224-235 
Baron  Larrey,  130,  271 
Baronets  of  Nova  Scotia,  17 

of  Ulster,  17 
Barton,  John  Ehea,  Professorship,  141 
Battle  of  Chippewa,  29 

of  Germantown,  14,  29,  30 

of  Gettysburg,  133 
Bay  of  Larne,  9 
Beadle,  Kev.  Elias  K.,  286 
"  Birchen  age  "  of  American  education,  37 
Birth  of  Dr.  D.  Haves  Agnew,  19 
Black  Douglas,  9,  10 
Blair  Castle,  12 

defense  of,  13 
Bleeding  in  surgery,  358 
Bliss,  Dr.,  in  the  Garfield  case,  221-249 
"  Blockley,"  108 

amusing  story  of,  109 
Boerhaave,  355 
Books  and  articles  published  by  Dr.  Agnew, 

193-196 
Brig  O'Doon,  9 
"  Broad  hints  "  of  Sir  Andrew  Agnew,  15 

humorous  story  of,  15 
Bruce,  Edward,  7 

Lady,  15 

Robert,  7 
Burying- ground  at  Gettysburg,  22 
Business  venture.  Dr.  Agnew's,  60 

Camp-meeting,  37 

Camp-story,  14 

Castle  of  Lochnaw,  6,  7 

captured  by  one  M'Clellan,  8 
retaken  by  one  of  the  Agnews,  8,  9 

Charles  I,  17 


Charles  II,  18,  20,  21 
Charles  V,  120 
Chloroform  in  surgery,  357 
Church  of  Ireland,  20 
Civil  War,  48,  91,  108,  113,  131,  359 
Cleeman,  Dr.  R.  A.,  address  by,  312 
Clinical  instruction  at  the  University,  139— 
142 

Surgery.  Chair  of,  139 
Club,  Friday-Evening,  269 

Monday-Evening,  269 

Penn,  reception  to  Dr.  Agnew,  317 

Saturday-Night,  273 

Social  Surgical,  270 

Thursday-Evening,  270 
College  of  Physicians,  126,  267,  341 
Colonization  of  the  North  of  Ireland,  20 

Society,  American,  128 
Colony,  Liberian,  128 
Commencement  eve  at  Musical  Fund  Hall,. 

50 
Comment  vons  portez  vous,  15 
Conquest  of  Ulster,  6 
Constable  of  Lochnaw,  7,  9 
Consulting  surgeon.  Dr.  Agnew  as,  131 
Cornelius  R.  x^gnew,  34 
County  AVigtown,  5,  21 

Hereditary  Sheriff  of,  5 
Cranial  and  heart  wounds,  medico-legal  as- 
pects of,  197-206 
Cromwell,  18 
Curator,  Dr.  Agnew  as,  113 

D'Agneanx,  see  Agneaux. 

Da  Costa,  Dr.  J.  M.,  address  by,  302 

Daniel  Agnew,  34,  135 

David  Agnew,  24,  63 

descendants  of,  24 
David  Haves  Agnew,  21,  25,  36 
Death  of  i)r.  D.  Hayes  Agnew,  340 

of  President  James  A.  Garfield,  232' 
Delaware  College,  41 
Department  of  Manche,  2 
Derivation  of  family  name  of  Agnew,  1 
Douglas,  Black,  9,  10 

Earl,  8,  9 

Sir  William,  9 
Dr.  D.  Hayes  Agnew,  year  of  birth,  19 

year  of  death,  19 
Duck-shooting,  57,  58 
Dukes  of  Argyle,  16 

Earl  Douglas,  8 
Earl  of  Moray,  7 

of  Strigul,  3 
Earliest  record  of  the  Agnew  family,  L 
Earls  of  Rothes,  16 

of  Tvrone  and  Tyrconnel,  19 
Early  life  of  Dr.  Agnew,  36-59 

m  Philadelphia;,  106 
Edward  Bruce,  7 


INDEX. 


373 


Eels  as  assiRtants  in  stiulying  anatomy,  71 
Eiiugratioii  to  rennsylvania,  20 
Erwiii  Agiiow,  33 
Ether  in  surgery,  283,  357 

frolics,  357 
Exiles  from  France,  3 

Faculty  of  the  University  of  Pennsylvania, 

43,  47,  137 
Family  name  of  Agnew,  derivation  of,  1 

tradition,  3 
Favorite  Galloway  story,  11 
"  Fax  mentis  honesta;  gloriae,"  18 
Female  students,  Dr.  Agnew's  objection  to, 

145 
Ferdinand  de  Soto,  123 
Feudalism,  essence  of,  6 
Fire  at  the  University  of  Pennsylvania,  53 
Firth  of  Clyde,  7 
Fox-hunting,  56 
Francklyn  Cottage,  231 
Franklin  Institute,  275 

Medical  College,  96 
French  chivalry,  knights  of,  3 
Friday-Evening  Club,  269 
Frolics,  ether,  357 
Funeral  of  Dr.  D.  Hayes  Agnew,  341 

address  at,  by  Dr.  Macintosh,  344 

services  at,  343-352 

Galloway,  5,  7,  8 

lordship  of,  10 

Scots  of,  8 

sheriff  of,  5,  18 

story,  favorite,  11 
Garfield  case,  220-249 

discussion  on  treatment  in,  236-242 

incident  in  the,  168 

physicians  in  attendance,  221,  224 
Genealogy  of  the  American  Agnews,  23 
General  Janies  Agnew,  14,  29,  30 

Winfield  S.  Hancock,  133 
"  Gentlemen's  law,"  6 
Gettysburg,  Battle  of  133 
"  'Ginny  students,"  48 
Gold  medal  presented  to  Dr.  Agnew,  315 
Goldsmith,  118 

Graduating  thesis.  Dr.  Agnew's,  53,  54 
"Green  Box,"  or  "Green  Room,"  50 
Gross,  Prof.  Samuel  W.,  address  by,  315 
Guiteau,  220,  242 
Gunshot  wounds,  132 

Hamilton,  Dr.  Frank  II.,  224-249 
Henderson,  James  N..  29,  37 

Rev.  Ehenezer,  25 
Heraldic  achievements  of  the  Agneaux,  3 

bearing  of  Agneaux  de  I'lsle,  3,  4 
"  Here  me  is,"  38 

Hereditable  jurisdictions,  abolishment  of,  16 
Hereditary  Sheriff  of  Wigtown,  5,  8 


Hereditary  Sheriffs  of  Galloway,  18 
llestonville  (Jeneral  Hospital,  131 
Hoge,  Rev.  Moses  D.,  258,  343,  349 
Hospital,  Alnishonse,  47 

Blockley,  108  ^ 

Hestonville  General,  131 

Mower  General,  131,  133,  360 

Orthopedic,  108,  149 

Pennsylvania,  46,  47,  107,  143 

Phila<lelphia,  47.  90,  107,  108 

Presbyterian,  275 

Satterlee  General,  131,  133 

University,  154 

Wills'  Eye,  107,  142 
House  of  Refuge,  126,  273 
Huguenots  at  time  of  Reformation,  3 
Hunter,  Dr.  Charles  T.,  159 

John,  355 
Hymn,  Wesley's  last,  263 

Infidels,  services  against,  4 
Instruments  devised  by  Dr.  Agnew,  174-177 
Iron  industr}'  of  Pennsylvania,  63 
Irwin  &  7^gnew,  firm  name,  67 

failure  of,  67,  68 
Irwin  family,  54 

Margaret  Creighton,  38,  54 

James  Agnew,  21,  23 
descendants  of,  24 

James  I,  19,  20 

James  II,  20,  21 

Jean  Jacques  Ren6   de   Ste.   Marie   d' Ag- 
neaux, 4 

Jefferson  College,  Cannonsburgh,  Pa.,  40 

John  Brown's  invasion  of  Virginia,  91 

John  Holmes  Agnew,  33,  41,  126,  135 

John  P.  Agnew,  63 

"  John  Rhea  Barton  Professorship  of  Sur- 
gery," 141  _ 

Journals,  medical,  356 

Jubilee  of  Dr.  Agnew,  288-317 

Judge  M.  Russell  Thayer,  337 

Kane,  124 

Kepler,  125 

King  David  II,  7,  9 

King  James  I,  10,  17 

King  of  Ireland,  7 

King  Robert  Bruce,  7 

Kirkcudbriglit,  5 

Knights  of  French  chivalry,  3 

La  Manche,  2 

"  Lacon,"  124 

Lady  Bruce,  15 

Laird  of  Lochnaw,  9 

Lamb,  Dr.  D.  S.,  233,  235 

Lammermuir  lion,  14 

Lancaster  County  Medical  Society,  266 

Lame,  bay  of,  9 


374 


INDEX. 


Larne,  Lord  of,  6,  7 

lough  of,  7 
Latta,  Eev.  Francis,  39,  40 
Laudanum  in  surgery,  358 
Law  of  Signatures,  354 
Lectures,  Dr.  Agnew's,  49, 138,  155, 166,  318 

last  didactic  lecture  at  the  University 
of  Pennsylvania,  321-331 
Leidy,  Dr.,  at  the  University,  78 
Liberian  colony,  128 
Life,  Dr.  Agnew's  early,  36 

in  Philadelphia,  106 

of  Dr.  Agnew  from  1860  to  1870,  128 
Lincoln,  Abraham,  128 

Dr.  N.  S.,  224 

William  R.,  address  by,  315 
Line  of  the  Alencourts,  4 
Lineage  of  the  Agnew  family,  1—35 
Lochnaw,  6,  7 

castle  of,  6,  7,  9,  10 

Constable  of,  7,  9 

Laird  of,  9 

loch  of,  9 
Lord  of  Alencourt,  4 

of  Larne,  6,  7 

of  risle  and  Auval,  3 
his  heraldic  bearing,  3 
Lords  of  Ulster,  7 
Lordship  of  Larne,  6 
Loving  cup,  272 

Macintosh.  Rev.  John  S.,  288,  301,  344 

his  reminiscences  of  Dr.  Agnew,  288- 
297 
MacVeagh,  Wayne,  224 
Marquis  de  Ste.  ilarie  d'Agneaux,  2 
Mason's  and  Dixon's  Line,  64.  70 
Mausoleum  at  West  Laurel  Hill  Cemetery, 

252 
Medical  instruction  of  fifty  years  ago,  45-50 

Institute,  49,  96,  140 

journals,  356 

Society  of  the  State  of  Pennsylvania, 
268 
Memorial  sermons,  351,  352 
Memorial  to  Dr.  Agnew,  352 
"  Merchant  of  Venice,"  119 
Mitchell,  Dr.  S,  Weir,  poem  by,  309 
"  Mixed  cliniques,"  148 
Monday -Evening  Club,  269 
Moscow  Acadernv,  39 
Mower  General  Hospital,  131,  133,  360 
Murrays  of  Philiphaugh,  16 
Museum,  Pathological,  113 

Wistar  and  Horner,  332 
Museums,  medical,  269 

Name,  Agnew,  numerous  ways  of  spelling,  1 

derivation  of,  1 
Napoleon,  40.  123 
Nestor  of  American  surgery,  269 


Newark  College,  Delaware,  41 
Noble  family,  28 
Norman  conquest  of  England,  3 
Normans,  or  Norsemen,  2 
Nova  Scotia,  baronets  of,  17 

special  honors  granted  to,  17 

Ode  by  Dr.  Thomas  Wistar,  312 

Olderfleet  Castle,  7 

Origin  of  name  of  Agnew,  1 

of  town  of  Agnew,  Nebraska,  1 
Original  investigations,  177-192 

work  in  surgery,  173 
Orthopedic  Hospital,  108,  149 

Painting  of  Dr.  Agnew,  332 

presentation  remarks  by  Dr.  J.  A.  Scott, 
332 

reception  speech  by  Dr.  S.  Weir  Mit- 
chell. 334 

reply  of  Dr.  Agnew,  334 
Pathological  ]\Iuseum,  113 
Patrick  Agnew,  11 

Penn  Club  reception  to  Dr.  Agnew,  317 
Pennsylvania,  emigration  to,  20 
Pennsylvania  Academy  of  Medicine,  101 

Hospital.  46.  47,  107,  143 

Medical  College,  110 
Pepper,  Provost,  address  by,  315 
Perkin's  tractors,  354 
Philadelphia  Anatomical  Rooms,  78,  82,  83 

Association  for  Medical  Instruction,  96, 
97 

Countv  Medical  Societv,  110,  126,  149, 
267,  341  ■' 

Dental  College,  275 

Hospital,  47,  90,  107,  108 

Polyclinic  and  College  for  Graduates  in 
Medicine,  95 

School  of  Anatomy,  74-116 
its  history,  76-105 
receipts  from,  92 

School  of  Operative  Surgery,  84 
fees  from,  92 

University  of  Medicine  and  Surgery,  154 
Phvsicans.  American,  356 
Pleasant  Garden  Iron- Works,  54,  60,  63,  66 

ruins  of  68 
Portrait  of  Dr.  Agnew  (frontispiece),  314 

of  Dr.  Alfred  Stille.  315 
Post-mortem  of  body  of  President  Garfield, 

233-235 
Presbyterian  Hospital,  275 
Princess  Margaret,  10 

ilary.  10 
Princeton  College,  159 
"  Principles  and  Practice  of  Surgery,"  160 

translated  into  Japanese,  163 
Private  classes,  48,  49 
Protestant  exiles  from  France,  3 
Providence,  116,  127 


INDEX. 


375 


Quiz  classes,  49,  76 
clubs,  49 
work,  95 

Rebellion,  War  of  tlio,  128 
Record  of  the  Agnew  family,  earliest,  1 
Reminiscences  ot  Dr.  Agnew,  288-297 
Resurrectionists,  89 

Retirement  from  the  University  of  Pennsyl- 
vania, Dr.  Agnew's,  318-338 
Rev.  David  C.  A.  Agnew,  3 

Elias  R.  Beadle,  286 

Francis  Latta,  39,  40 

John  Holmes  Agnew,  41,  126 

John  S.  Macintosh,  288 

Matthew  Brown,  40 
Reyburn,  Dr.  Robert,  224,  235 
Richard  de  Clare,  3 
Robert  Agnew,  Dr.  Agnew's  father,  25,  26 

description  of,  26,  27 
Robert  and  Antoine  Agneaux,  4 
Robert  Bruce,  7 
Robert  III,  9 

Royal  descent  of  the  Agnews,  11 
Rush,  Benjamin,  355 

Sabbath,  Dr.  Agnew's  observance  of  the, 
126,  257 

Saint-Lo,  city  of,  2 

Samuel  Agnew,  21 

"  Sapientia  cum  latitia,"  272 

Satterlee  General  Hospital,  131,  133 

Saturday-Night  Club,  273 

Sayre,  Dr.  Lewis  A.,  address  by,  308 

School,  Viennese,  355 

School  of  Anatomy,  52,  74,  116 
of  Medicine,  96 
of  Operative  Surgery,  84,  92 

Scotch  branch  of  Agnew  family,  5,  8 

Scots  of  Galloway,  8 

Sermons,  memorial,  351,  352 

Services  against  the  infidels,  4 

Sheriff  of  Galloway,  5,  18 
of  Wigtown,  5,  8,  9,  16 

Sickness  of  Dr.  D.  Hayes  Agnew,  339 

Signatures,  Law  of,  354 

"  Similia  Similibus  Curantur,"  354 

"Sinister  hand  of  Ulster."  6 

Sir  Andrew  Agnew,  126 

Sir  Andrew  Agnew,  a  famous  soldier,  11,  18 
"  broad  hints  "  of,  15 
camp-story  in  reference  to,  14 
favorite  Galloway  story  of,  11 
his  prejudice  against  the  French,  15 
incidents   of,  described   by  Sir  Walter 
Scott,  12 

Sir  Andrew  Agnew,  Bart.,  M.P.,  10,  18 

Sir  Andrew  Noel  Agnew,  19 

Sir  Fulke  d'Agneaux,  4 

Sir  John  d'Agneaux,  4 

Sir  Philip  d'Agneaux,  4 


Sir  William  d'Agneaux,  4 
Sir  Patrick  Agnew,  18 

descendants  of,  18 
Sir  William  Douglas,  9 
Slavery,  the  subject  of,  52 

address  on,  by  Dr.  Agnew,  129 
Smith  Agnew,  23 
Social   life,  relation   of,  to  surgical  disease, 

207-219 
Song,  written  by  J.  H.  Adams,  315,  316 

music  to,  by  Hugh  A.  Clarke,  316 
"  Southern  Agnews,"  21 
Southern  students,  91,  129 
Specialties,  360 

Speech  on  abolition  of  slavery,  129 
Ste.  Marie  d'Agneaux,  4 
Stille,  Dr.  Alfred,  portrait  of,  315 

Library,  damaged  during  fire  at  Univer- 
sity, 53 
Story,  favorite  Galloway,  11 
"  Strong  Bow,"  3 
"  Summer  Association,"  97 

brilliant  teachers  and  writers,  100 
Surgeon  of  Volunteers,  Dr.  Agnew,  131 
Surgeons,  distinguished,  fifty  years  ago,  47- 

49 
"  Surgeons'  House,"  256 
Surgery,  bleeding  in,  358 

chloroform  in,  357 

ether  in,  283,  357 

laudanum  in,  358 
Surgery,  Clinical  Chair  of,  139 

Dr.  Agnew's  original  work  in,  173 
position  in,  353-364 

John    Rhea    Barton   Professorship   of, 
141 

"  Principles  and  Practice  of,"  160,  281 
translated  into  Japanese,  163 
Surgical  Club,  Social,  270 
Surgical   disease,  relation  of  social   life  to, 
207-219 

operations  before  introduction  of  ances- 
thesia,  47 

Thayer,  Judge  M.  Russell,  337 
Thursday-Evening  Club,  270 
Tractors,  Perkin's,  354 
Tradition,  family,  3,  8 

Translation    of    "  Virgil "   into    French   in 
1582,  4 

Ulster,  baronets  of,  17 

conquest  of,  6 

lords  of,  7 

sinister  hand  of,  6 
Union  Trust  Company,  Dr.  Agnew  a  Director 

of,  274 
University  of  Pennsylvania,  42,  47,  52,  108, 
137,  154 

Alumni  Society  of,  275 

clinical  instruction  at  the,  139-142 


376 


INDEX. 


University  of  Pennsylvania,  Dr.  Agnew  at 
the,  136 
address  on  retirement  from,  331 
last  didactic  lecture  at,  821-331 
retirement  from  the,  318-338 
Dr.  Leidy  at  the,  78,  137 
faculty  of  medicine  at,  43,  47,  137,  156, 
276   . 
description  of,  43-45 
hospital   of,  inaugurated   by  Governor 

Hartranft,  154 
removal  to  West  Philadelphia,  154 

Valedictory  address,  116-126 
Various  ways  of  spelling  the  name  of  Ag- 
new, 1 
Venture  in  business.  Dr.  Agnew's,  60 
Viennese  School,  355 
Voltaire,  121 
Volunteers,  Dr.  Agnew  surgeon  of,  131 

Wales,  Surgeon-General,  224,  226 
Wallace,  Mary  A.,  29,  69 
War,  Civil,  48,  91,  108,  113,  131 


War  of  1812,  32 

of  the  Rebellion,  128 
Warburton  Anatomy  Bill,  90 
Washington  to  Elberon,  231 
Wesley's  last  hymn,  263 
West  Laurel  Hill  Cemetery,  mausoleum  at, 

.  352 
Wigtown,  5,  21 

Sheriff  of,  5,  8,  9,  16 
William  the  Conqueror,  3,  6 
Wills'  Eye  Hospital,  107,  142 
Windmill  Street  School,  London,  76,  303 
Wistar  and  Horner  Museum,  332 
Wistar  Association,  273 
Wistar,  Dr.  Thomas,  ode  by,  312 

Parties,  273 
Women's  Medical  College,  144 
Woodward,  Surgeon  J.  J.,  224,  233,  235 
Wounds,  cranial  and  heart,  medico-legal  as- 
pects of,  197-206 
Writings,  Dr.  Agnew's,  113-116,  193 
"  Wyndrift,"  251 

Xenophon,  117 


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